Subject: Re: idiopathic causes of pancreatitis
Forum: The Gastroenterology and Liver Diseases Forum

Topic Area:

Topic Area: Pancreas
My doctor has mentioned herbs as a possible cause of the attack of severe pancreatitis I had about a year ago. I'm a vegetarian, non-drinker and had healthy cholesterol and triglyceride levels and no indication of gall bladder problems. I still have pseudocysts not completely resolved and am anxious never to experience pancreatitis again. Are there herbs known or suspected to cause pancreatitis? Drugs? Foods? What are they?

Dear Andrea,

A long list of medications have been shown to be important in the development of acute pancreatitis. Immunosuppressive agents (6 MP, azathioprine), sulfasalazine, trimethoprim/sulfa, olsalazine, mesalamine, antibiotics (metronidazole, tetracycline), valproic acid, steroids, diuretics, estrogens, pentamidine, didanosine (medicine against HIV infection), octreotide and others have been implicated. A variety of foods have been shown to cause recurrent episodes of acute pancreatitis, including, milk, eggs, beef, potato, and fish. I performed a brief literature search to look for specific herbal preparations reported to cause acute pancreatitis. I did find one case report of a fatal ingestion of a compound called oil of "epazote" or oil of chenopodium. The case was a 2 yr old female who received a large dose of this compound. Part of the spectrum of this fatal poisoning included a mild pancreatitis. Whether or not the pancreatitis was directly related to ingesting this compound or related to the severity of illness is unclear from this report. No other herbal preparations were found to be associated with the development of acute pancreatitis during my literature search. On the other hand, it does seem reasonable to speculate that just as medications are implicated in acute pancreatitis, herbal preparations may do so as well. The best way to prove this hypothesis (I'm not recommending that you do this) is to introduce an herbal preparation, document the presence of acute pancreatitis, withdraw the drug, note the resolution of the acute episode and reintroduce the drug. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: acute pancreatitis, food, drugs, herbs

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