Epidemiology and Pathophysiology of Tropical Chronic Pancreatitis

This chapter presents an extensively reviewed update on the epidemiology and pathophysiology of tropical chronic pancreatitis (TCP). Despite a lack of large-scale epidemiological evidence, there is a definite decline in the incidence of TCP around the world, including in the developing countries from which the disease rose to prominence. Although the pathologic changes accompanying the disease and the genetic mutations have been well understood for some time, there has recently been a paradigm shift in our understanding of the etiology of the disease. The reduced emphasis on macronutrient, protein calorie malnutrition, and cassava ingestion as etiologic factors has made way for micronutrient deficiency (including zinc) and oxidant stress, as more plausible underlying factors. Finally, the natural history of the disease is discussed in the light of the most recent evidence, suggesting significantly improved survival as a result of better management of the disease and its attendant complications.