RELATIONSHIP OF BASAL AND POSTPRANDIAL INTRADUODENAL BILE-ACID CONCENTRATIONS AND PLASMA CHOLECYSTOKININ LEVELS WITH ABDOMINAL-PAIN IN PATIENTS WITH CHRONIC-PANCREATITIS

Abdominal pain in patients with chronic pancreatitis has been related to an increase in plasma cholecystokinin (CCK) levels. The aim of the study was to disclose the relation of the altered response with the lo w intraduodenal bile acids levels found in these patients. Twenty pati ents with chronic pancreatitis were classified into groups I (n = 11) and II (n = 9) according to the presence or absence of pain. Intraduod enal trypsin and bile acids concentrations and plasma CCK levels were measured before and 30, 60, and 90 min after a test meal. Comparisons between values in both groups were carried out. Correlation of intradu odenal trypsin and bile acids with plasma CCK was analyzed. Patients w ith pain exhibited significantly lower intraduodenal trypsin levels at 30 and 90 min and lower basal and postprandial intraduodenal bile aci ds levels than patients without pain. In patients with pain, basal and postprandial plasma CCK levels were significantly higher than in pati ents without pain. A negative correlation was demonstrated between int raduodenal bile acids and plasma CCK. In patients with chronic pancrea titis and pain, a reduction in intraduodenal postprandial trypsin and basal and postprandial bile acids concentrations, as well as an increa se in basal and postprandial plasma CCK levels, was encountered. A neg ative correlation between intraduodenal bile acids and plasma CCK conc entrations was detected that may be implicated in the pathogenesis of pain.