# Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus

## TL;DR

This study finds that inflammatory bowel disease increases the risk of acute pancreatitis, suggesting a need for closer monitoring in IBD patients.

## Contribution

The study identifies a causal link between inflammatory bowel disease and acute pancreatitis using Mendelian randomization.

## Key findings

- Genetically predicted IBD is associated with a 7% increased risk of acute pancreatitis.
- Both ulcerative colitis and Crohn’s disease subtypes show increased risks of acute pancreatitis.
- No reverse causality was found between other autoimmune diseases and pancreatitis.

## Abstract

We explored the causal relationship between pancreatitis and various autoimmune diseases using bidirectional Mendelian randomization (MR).

We collected genome-wide association study summary data for four pancreatitis types and five autoimmune diseases to conduct our bidirectional MR analysis. The primary analysis was performed using the inverse variance weighted (IVW) method, complemented by MR Egger, weighted median, and weighted mode methods. Sensitivity analyses included Cochran’s Q test for heterogeneity, MR-Egger regression for pleiotropy, and MR-PRESSO and leave-one-out analyses for outliers.

The result of IVW revealed a significant association between genetically predicted inflammatory bowel disease (IBD) and an increased risk of acute pancreatitis (AP) (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 1.03–1.12, P = 0.0015). Subsequent analyses further confirmed this association in IBD subtypes, with genetically predicted ulcerative colitis (UC) and Crohn’s disease (CD) also showing increased risks of AP (UC: OR = 1.07, 95% CI = 1.02–1.13, P = 0.01; CD: OR = 1.05, 95% CI = 1–1.09, P = 0.03), affirming IBD as a risk factor for pancreatitis. Reverse analysis ruled out reverse causality and did not find a causal relationship between other immune diseases and pancreatitis.

These findings suggest that pancreatitis in IBD patients may arise from the disease itself, necessitating increased vigilance for AP during diagnosis and treatment.