ABSTRACT
THE PURPOSE OF THE RESEARCH: To study the cavitary esophagogastroduodenal pressure in patients with chronic pancreatitis (CP) depending on the dominant clinical symptoms--gastroesophageal reflux (GER) and abdominal pancreatic pain. MATERIAL AND METHODS: By esophagogastroduodenoscopy that included manometrography and acid-perfusion test--were examined 86 patients with CP and 25 healthy individuals. RESULTS: 63% of patients with CP detected changes of the esophagus and the lower esophageal sphincter (LES) based on the endoscopy, or manometrography, or test with 0.1N hydrochloric acid solution. The presence of GER compared with its absence in patients with CP was associated with significantly lower rates LES pressure and pressure gradients between the LES and antral stomach and between the LES and duodenum. Patients with CP with leading pancreatic abdominal pain syndrome compared with patients with GER signs and without GER signs were found the lowest pressure LES and pressure gradients between the LES and the pyloric stomach, LES and the duodenum. The presence of heartburn in patients with CP without erosive esophagitis found correlative connection with positive endoscopic acid-perfusion test and the pressure drop in the LES. CONCLUSION: Integrated upper endoscopy, including endoscopic manometrography and esophageal acid-perfusion test in clinical studies increases the frequency of detection of non-erosive reflux disease and one of its predictors--reduced esophago-gastric pressure gradient.
