INTRODUCTION Pancreatitis in inflammatory bowel disease has been attributed to peripancreatic intestinal disease and/or drug-induced pancreatic toxicity. We used large cohort analyses to define inflammatory bowel disease and pancreatitis temporal co-occurrence with a detailed descriptive analysis to gain greater insight into the pathophysiological relationship between these 2 diseases. METHODS Truven Health MarketScan private insurance claims from 141,017,841 patients (younger than 65 years) and 7,457,709 patients from 4 academic hospitals were analyzed. We calculated the prevalence of Crohn's disease or ulcerative colitis (UC) with acute pancreatitis or chronic pancreatitis (CP) and performed temporal and descriptive analyses. RESULTS Of 516,724 patients with inflammatory bowel disease, 12,109 individuals (2.3%) had pancreatitis. Acute pancreatitis (AP) was 2-6x more prevalent than CP. In adults, AP occurred equally among Crohn's disease and UC (1.8%-2.2% vs 1.6%-2.1%, respectively), whereas in children, AP was more frequent in UC (2.3%-3.4% vs 1.5%-1.8%, respectively). The highest proportion of pancreatitis (21.7%-44.7%) was at/near the time of inflammatory bowel disease diagnosis. Of them, 22.1%-39.3% were on steroids during pancreatitis. Individuals with CP or recurrent pancreatitis hospitalizations had increased risk of a future inflammatory bowel disease diagnosis (odds ratio = 1.52 or 1.72, respectively). DISCUSSION Pancreatitis in inflammatory bowel disease may not simply be a drug adverse event but may also involve local and/or systemic processes that negatively affect the pancreas. Our analysis of pancreatitis before, during, and after inflammatory bowel disease diagnosis suggests a bidirectional pathophysiologic relationship between inflammatory bowel disease and pancreatitis, with potentially more complexity than previously appreciated.

中文翻译：

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美国儿童和成人炎症性肠病和胰腺炎同时发生的时间分析。

引言 炎症性肠病中的胰腺炎归因于胰周肠道疾病和/或药物引起的胰腺毒性。我们使用大型队列分析来定义炎症性肠病和胰腺炎的时间共存，并进行详细的描述性分析，以更深入地了解这两种疾病之间的病理生理学关系。方法 Truven Health MarketScan 对来自 141,017,841 名患者（65 岁以下）和来自 4 家学术医院的 7,457,709 名患者的私人保险索赔进行了分析。我们计算了克罗恩病或溃疡性结肠炎 (UC) 合并急性胰腺炎或慢性胰腺炎 (CP) 的患病率，并进行了时间和描述性分析。结果 在 516,724 名炎症性肠病患者中，12,109 名患者 (2.3%) 患有胰腺炎。急性胰腺炎 (AP) 的患病率是 CP 的 2-6 倍。在成人中，AP 在克罗恩病和 UC 中的发生率相同（分别为 1.8%-2.2% vs 1.6%-2.1%），而在儿童中，AP 在 UC 中更为常见（2.3%-3.4% vs 1.5%-1.8%）。分别）。胰腺炎的比例最高（21.7%-44.7%）是在炎症性肠病诊断时/附近。其中，22.1%-39.3%在胰腺炎期间服用类固醇。患有 CP 或复发性胰腺炎住院的个体未来诊断炎症性肠病的风险增加（比值比分别 = 1.52 或 1.72）。讨论 炎症性肠病中的胰腺炎可能不仅仅是药物不良事件，还可能涉及对胰腺产生负面影响的局部和/或全身过程。我们对炎症性肠病诊断之前、期间和之后的胰腺炎进行的分析表明，炎症性肠病和胰腺炎之间存在双向病理生理学关系，其复杂性可能比之前认识的更为复杂。