We have conducted a field study in India in the state of Kerala involving 28,567 inhabitants to determine the prevalence and clinical features of
chronic pancreatitis of the tropics (
CPT), an illness that is endemic in several regions of India. Selection criteria for the present study included: 1. Characteristic
abdominal pain; 2. Evidence of
diabetes mellitus; and 3. Evidence of
malnutrition/malabsorption. A diagnosis of chronic
calcific pancreatitis (CCP) was established by evidence of either 1, 2, or 3 plus X-ray evidence of pancreatic
calculi. Diagnosis of noncalcifying
chronic pancreatitis (NCCP) was established by 1, 2, or 3 plus an abnormal ultrasound of the pancreas and an abnormal
bentiromide test.
CPT was discovered among 36 individuals (prevalence 1:793). Strict entry criteria may have excluded additional cases.
CPT was far advanced at the time of diagnosis in that 28 had evidence of calcification, 19 had
diabetes mellitus, and 27 had an abnormal
bentiromide test. The major differences from previous hospital-based studies were female predominance (male/female ratio, 1:1.8), onset of disease at an older age (mean 23.9 yr), and evidence of milder disease. We conclude that previous hospital-based reports that
CPT is a severe illness with a male predominance may reflect greater access of seriously ill individuals in general and males in particular to medical care.