Increased subsequent risk of inflammatory bowel disease association in patients with chronic pancreatitis: a nationwide population-based cohort study

Abstract

Purpose: To investigate the relationship between chronic pancreatitis (CP) and inflammatory bowel disease (IBD) in a large population-based cohort study.

Methods: Data was obtained from the Taiwan National Health Insurance Research Database. The cohort study comprised 17,796 patients newly diagnosed with CP between 2000 and 2010 and 71,164 matched controls. A Cox proportional hazards model was used for evaluating the risk of IBD in the CP and comparison cohorts.

Results: When examined with a mean follow-up period of 4.87 and 6.04 years for the CP and comparison cohorts, respectively, the overall incidence of IBD was 10.3 times higher in the CP cohort than in the comparison cohort (5.75 vs. 0.56 per 10,000 person-years). Compared with the comparison cohort, the CP cohort exhibited a higher risk of IBD, irrespective of age, sex, and presence or absence of comorbidities. Moreover, the CP cohort was associated with a significantly higher risk of Crohn’s disease (adjusted hazard ratio [aHR] = 12.9, 95% confidence interval [CI] = 5.15–32.5) and ulcerative colitis (aHR = 2.80, 95% CI = 1.00–7.86).

Conclusions: This nationwide population-based cohort study revealed a significantly higher risk of IBD in patients with CP compared with control group. Clinicians should notice this association to avoid delayed diagnosis of IBD in patients with CP.

Keywords:

• Chronic pancreatitis
• Crohn’s disease
• Inflammatory bowel disease
• Taiwan National Health Insurance Research Database
• Ulcerative colitis

Transparency

Declaration of funding

This study is supported in part by Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (TCRD-TPE-105-30); Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST105-2325-B-039-003), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.

Author contributions: F.-C.S. and J.-A.L. contributed equally. Conception/design: Y.-L.C. and J.A.; provision of study materials: F.-C.S. and J.-A.L.; data collection and assembly: all authors; data analysis and interpretation: all authors; manuscript preparation: all authors; final approval of manuscript: all authors.

Declaration of financial/other relationships

Y.-L.C., C.-W.H., C.-C.C., G.-T.Y., C.-S.L., C.-L.L., F.-C.S., and J.-A.L. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.