Pancreas and Inflammatory Bowel Diseases

Pancreatic involvement is an important extraintestinal manifestation of Crohn's disease and ulcerative colitis. Though not especially common from a symptomatic standpoint, a quite significant percentage of patients exhibit asymptomatic involvement, either in the form of elevated pancreatic enzymes or as abnormal pancreatic imaging in ERCP or MRCP studies. Still, it remains unclear how pancreatic involvement correlates with the long-term prognosis of IBD. Moreover, further research is needed to ascertain the mechanisms of injury. It is worth noting that in a handful of reports pancreatic involvement precedes the diagnosis of IBD. Lately the evidence that support more than an accidental association of pancreatitis and pancreatic insufficiency in patients with IBD is growing. According to present data, pancreatic disease seems to be one of the extraintestinal manifestations in IBD patients, especially in those with primary sclerosing cholangitis, so that increased awareness of the possible pancreatic involvement in IBD is recommended.