EFFECT OF OMEPRAZOLE ON CHANGES IN GASTRIC AND UPPER SMALL-INTESTINE PH LEVELS IN PATIENTS WITH CHRONIC-PANCREATITIS

Gastric and upper small intestine pH levels were measured continuously over 24 hours in patients with chronic pancreatitis, and values obtai ned before and after the administration of omeprazole were compared. A dditionally, omeprazole was administered for 2 weeks and the fecal exc retion of fat was compared before and after drug therapy. Postprandial gastric pH levels, initially 2.9 to 3.2, increased by 1.6 to 2.1 afte r treatment. Postprandial upper small intestine pH levels, initially 5 .1 to 5.5, increased by 0.7 to 1.0. The lowest pH value of the upper s mall intestine was 2.2 to 2.4 postprandially; this was increased by >1 .0 after omeprazole, and the amplitude of pH variation was reduced. Th e cumulative proportions of intraintestinal pH strata of less than or equal to 3, less than or equal to 4, or less than or equal to 5, and h igher, initially being 16.4% to 17.1%, 27.4% to 31.7%, and 52.6% to 57 .8%, respectively, were remarkably improved after drug treatment. Gast ric pH and upper small intestine pH levels showed a positive correlati on; an increase in gastric pH levels by 2 corresponded to an increase in small intestine pH levels by 1. After omeprazole administration, me an fecal excretion of fat was decreased to 4.1 +/- 2.6 g/d (range, 1.1 to 9.8 g/d) from 6.5 +/- 3.9 g/d (range, 1.6 to 13.5 g/d). Decreases in excretion of fat averaged 3.4 g/d (range, 2.2 to 4.5 g/d) in patien ts with steatorrhea. It was concluded that steatorrhea due to chronic pancreatitis can be improved to some extent by improving upper small i ntestine pH levels following the elevation of gastric pH levels after administration of omeprazole.