We thank Drs Balakrishnan1, Ramesh2 and Chandak3 for their interest in our study.4 We would like first to respond to the issue of the terminology because that is their common concern, and then to reply to the other issues.

When the term ‘tropical pancreatitis’ was first used in 1960s, the understanding of its pathogenesis was limited. Being described in India it was referred to as ‘tropical’, although this was inappropriate since there was no conceptual or scientific evidence of a climatic influence on its pathophysiology. Moreover, the disease was not seen or described in other tropical countries such as Brazil. The word ‘tropical’ usually refers to infectious diseases (eg, tropical myositis, tropical splenomegaly syndrome) as defined by the World Health Organization: ‘Tropical diseases encompass all diseases that occur solely, or principally, in the tropics. In practice, the term is often taken to refer to infectious diseases that thrive in hot humid conditions such as malaria, leishmaniasis, schistosomiasis, and dengue’ (http://www.who.int/topics/tropical_diseases/en/). There is no evidence of any infectious cause of chronic pancreatitis (CP) and its aetiology is now much better understood since …