Early and late onset in idiopathic and alcoholic chronic pancreatitis - Different clinical courses

Long-term alcohol consumption is the most frequent cause (65%-85%) of chronic pancreatitis in the Western world. Most of the remaining patients with chronic pancreatitis (10%-30%) are labeled with idiopathic chronic pancreatitis, which is not a homogenous entity but consists of an early-onset (i.e., juvenile) form that usually occurs within the first 2 decades of life and a late-onset (i.e., senile) form that occurs after the fifth decade. In contrast to alcoholic chronic pancreatitis, which predominantly involves men, both idiopathic forms have an equal Sender distribution, calcify less, and have fewer complications. There are, however, marked differences between the early- and the late-onset forms. Severe pain is the leading initial symptom in early-onset chronic pancreatitis, whereas most patients with late-onset chronic pancreatitis have no or only mild pain throughout the course of the disease. Conversely, calcification, exocrine insufficiency, and diabetes develop more slowly and less frequently in early- compared with late-onset chronic pancreatitis.