Published: 24-05-2023 10:33 | Updated: 24-05-2023 10:34

Microscopic colitis and the risk of acute pancreatitis

In a nationwide Swedish study of more than 12,000 patients with microscopic colitis (MC), researchers from Sahlgrenska University Hospital and Karolinska Institutet found an increased risk of acute pancreatitis compared to the general population. The study has been published in The American Journal of Gastroenterology.

Portrait of Dr David Bergman
Dr David Bergman. Foto: Gunilla Sonnebring

MC is one of the most recently recognized inflammatory conditions of the large intestine. As such, knowledge of the association to other disorders is limited. Earlier studies have suggested increased risks of acute pancreatitis, a potentially fatal disorder, in patients with inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, but data on patients with MC have, until now, been lacking.

In a nationwide Swedish study of more than 12,000 patients with MC, researchers found a 57% increase in the risk of acute pancreatitis in patients with MC compared to individuals from the general population. Data on MC were retrieved from the Nationwide histopathology cohort ESPRESSO.

The team also found that there was no increase in the risk of acute pancreatitis caused by gallstones. Followingly, the increased risk was driven by the stronger association to acute pancreatitis unrelated to gallstones. 

“We feel our work is of importance since it is the first study to date to address the association between MC and acute pancreatitis”, says lead author Dr David Bergman, M.D, PhD at the Department of Medical Epidemiology and Biostatistics. “Our findings add to the knowledge of associated inflammatory conditions in MC and underline the importance to provide advice and care aimed at minimizing the risk of acute pancreatitis in MC.”

Jonas Ludvigsson. Photo: Alexander Donka
Professor Jonas Ludvigsson. Photo: Alexander Donka

Similar results for men and women

The researchers also examined whether the association differed for men and women or by age below or above 50. The results for the different groups, however, were similar.

“More and more people are diagnosed with MC and asking for information about comorbidity. We are happy to be able to provide such information” says the last author Professor Jonas F. Ludvigsson, pediatrician at Örebro University Hospital, and Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

“Having access to longitudinal data on patients with MC, matched controls but also siblings to patients with MC allows us to calculate risks of severe complications and also to move the field forward by taking confounding from shared familial risk factors into account”, adds Ludvigsson.

The study was supported by the Karolinska Institutet, Stockholm County Council, and the National Institutes of Health. 

Dr. Ludvigsson has coordinated a study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from the Janssen Corporation. Dr Ludvigsson has also received financial support from MSD to develop a paper reviewing national healthcare registers in China. Dr Olén has been PI on projects at Karolinska Institutet financed by grants from Janssen, Pfizer, AbbVie, Takeda, and Ferring, and Karolinska Institutet has received fees for lectures and participation on advisory boards from Janssen, Ferring, Galapagos, Bristol Myer Squibb, Takeda, and Pfizer. Dr Olén also reports grants from Pfizer, Galapagos, and Janssen in the context of national safety monitoring programs.


Microscopic colitis and risk of incident acute pancreatitis: A nationwide population-based matched cohort study.
Bergman D, Roelstraete B, Olén O, Lindkvist B, Ludvigsson JF
Am J Gastroenterol 2023 May;():