Alcoholic pancreatopathy: a proposed new diagnostic category representing the preclinical stage of alcoholic pancreatic injury.

Alcoholic chronic pancreatitis (CP) is not usually diagnosed until the end stage of the disease, and hence enormous medical and social resources are consumed in the treatment of established alcoholic CP. With the aim of early diagnosis and prevention of alcoholic CP, we here propose "alcoholic pancreatopathy" as a new category of pancreatic disorder induced by alcohol intake. In addition to a history of excessive alcohol intake (>80 g/day), the presence of at least one of the following conditions establishes the diagnosis of alcoholic pancreatopathy: 1. History of alcoholic acute pancreatitis. 2. Recurrent abdominal pain or gastrointestinal symptoms induced by alcohol intake. 3. Hyperamylasemia or a high serum level of any other pancreatic enzymes. 4. Abnormal findings in the pancreas by routine abdominal ultrasonography. Alcoholic pancreatopathy is a comprehensive concept that includes the early stage of pancreatic injury induced by alcohol, and is useful for detecting the preclinical stage of pancreatic injury induced by alcohol and hence for treating the early stage of the disease. Further assessments and well-designed studies for investigating the early stage of alcoholic CP are necessary, in which alcoholic pancreatopathy could play a key role.