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Abstract
A total of 136 patients with a combination of chronic pancreatitis (CP), erosive, and ulcerative changes in the gastroduodenal zone, against a background of excess body weight, were examined. A comparison of morphological changes in the gastric mucosa in CP with and without Helicobacter pylori infection revealed a higher frequency of moderate and severe glandular atrophy in the antrum of the stomach in erosive and ulcerative lesions of the gastroduodenal zone without Helicobacter pylori.
The extreme rarity of intestinal metaplasia in the gastric mucosa in CP has been established. This may be due to a decrease in the neutralizing effect of pancreatic secretions, while the acidic environment prevents the development of intestinal metaplasia. However, G-cell hyperplasia was also found in the antrum of the stomach, a characteristic of Helicobacter pylori infection, accompanied by hyperplasia of acid-producing parietal cells in the fundus of the stomach.
Differences were found in the localization of erosions and ulcers in the group with CP and Helicobacter pylori in the gastric mucosa, mainly in the gastric antrum; in the group with CP without Helicobacter pylori, predominantly in the gastric fundus. In cases involving the use of non-steroidal anti-inflammatory drugs in these groups, differences in the localization of erosions and ulcers also persisted, although in the gastric fundus (in the CP group without Helicobacter pylori), they were shifted closer to the gastric antrum and localized in the prepyloric region or lower third of the stomach. A combination of CP and erosive-ulcerative lesions of the gastroduodenal zone against a background of excess body weight is characterized by a decrease in mucin production. A characteristic feature of chronic gastritis in combined diseases is a decrease in mucin production, which was well corrected by taking the drug rebamipide. This restored mucin production by the epithelium and reduced inflammatory cell infiltration.
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