Rising Cases of Acute Pancreatitis in Kashmir

Over the past decade, hospitalization rates for acute pancreatitis (AP) have significantly increased in the Kashmiri population, primarily due to gallstone (GS)-related cases. This rise is linked to lifestyle changes, including poor dietary habits, lack of exercise, and a sedentary lifestyle, leading to higher rates of obesity, diabetes, and non-alcoholic fatty liver disease (NAFLD).

Acute pancreatitis is a serious condition where the pancreas, a small organ behind the stomach, becomes inflamed over a short period. The pancreas plays a crucial role in digesting food and regulating blood sugar levels through hormones like insulin and glucagon.

AP is characterized by severe upper abdominal pain that often radiates to the back, accompanied by vomiting and elevated blood levels of enzymes such as amylase and lipase. Most AP cases improve within a week, but about 20% can become severe, leading to prolonged hospital stays, infections, and high treatment costs. Mortality in severe cases ranges from 10% to 20%, often due to multiorgan failure.

However, AP can largely be prevented by managing the risk factors that cause it. Given the high morbidity and mortality associated with severe AP, it is crucial to raise public awareness about the condition and adopt preventive measures to curb its increasing incidence.

Major causes of AP and Risk factors

The major causes of AP includes GS related AP, excessive consumption of alcohol,high blood lipid levels (hypertriglyceridemia), intestinal parasites like Ascaris lumbricoides in endemic areas and various drugs. The associated risk factors include smoking, obesity, high blood lipid levels, diabetes and certain genetic predispositions.The incidence of AP has increased worldwide and is one of the leading causes of gastrointestinal related hospital admissions.

The increased incidence is related to increased incidence of GS pancreatitis (GSP) involving elderly population with higher body mass index and obesity.Alcohol associated AP accounts for the highest proportion of AP in India involving younger male population followed by GS related AP.

Changing spectrum of AP in Kashmiri population:                                         

The hospitalization rate for acute pancreatitis (AP) in the Kashmiri population has steadily increased in recent years. Gallstones and pancreatic biliary ascariasis are the leading causes of AP in both adults and children. A study from SKIMS, published in the Indian Journal of Gastroenterology, highlighted a rise in AP-related hospital admissions from 5.6% in 2015 to 10.3% in 2019, nearly doubling in five years.

This increase is primarily due to gallstone pancreatitis (GSP), which rose from 31% to 52.4% during this period. Meanwhile, cases of Ascaris-related AP have significantly declined, likely due to better socioeconomic conditions, improved hygiene, and increased awareness about deworming.

The study also noted that asymptomatic gallstones, particularly multiple small ones (