title: Prevalence and pathogenesis of duodenal ulcer in chronic alcoholic pancreatitis.
abstract: BACKGROUND
  The prevalence of duodenal ulcer (DU) has been considered high in patients with chronic pancreatitis; however, its pathogenesis is unclear. We hypothesized that Helicobacter pylori infection plays the major pathogenetic role.
  
  
  METHODS
  One hundred seven cases (97 men, 10 women) of chronic alcoholic pancreatitis (CAP) were prospectively investigated from 1997 to 2001. One hundred thirty-seven DU patients and 59 nonulcer dyspepsia patients formed the two control groups. Pancreatic function was evaluated by determination of fecal fat excretion and fasting blood glucose concentration. Upper gastrointestinal endoscopy was performed in all patients, and gastric mucosal biopsies were taken for assessment of H. pylori infection with a modified Giemsa stain and rapid urease test.
  
  
  RESULTS
  Fifteen (14%) of the 107 patients with CAP had active DU. There was a trend toward an association between the presence of diabetes mellitus and/or steatorrhea and the occurrence of DU in patients with CAP (p = 0.06). The rate of H. pylori infection was significantly higher in patients with CAP and DU than in those with only CAP (86.7% vs. 54.3%, p = 0.02) but the rate similar to that in patients with simple DU (75.2%). Trends toward higher prevalence of H. pylori infection in CAP with DU were noticed when they were compared with the nonulcer dyspepsia group (86.7% vs. 66.1%). There was no significant difference in prevalence of H. pylori between CAP patients without DU and dyspeptic patients (54.3% vs. 66.1%).
  
  
  CONCLUSIONS
  These data demonstrate that the prevalence of DU in CAP is relatively high. H. pylori infection seems to play the major pathogenetic role in DU associated with CAP.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Federal University of Juiz de Fora-Minas Gerais, Brazil. chebli@hu.ufjf.br
authors.forename: Julio Maria Fonseca
authors.initials: JM
authors.lastname: Chebli
authors.forename: Aécio Flávio Meirelles
authors.initials: AF
authors.lastname: de Souza
authors.forename: Pedro Duarte
authors.initials: PD
authors.lastname: Gaburri
authors.forename: Kátia Valeria
authors.initials: KV
authors.lastname: Bastos
authors.forename: Tarsila Campanha Rocha
authors.initials: TC
authors.lastname: Ribeiro
authors.forename: Roberto José Carvalho
authors.initials: RJ
authors.lastname: Filho
authors.forename: Liliana Andrade
authors.initials: LA
authors.lastname: Chebli
authors.forename: Lincoln Eduardo V V
authors.initials: LE
authors.lastname: Castro Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D004381:Duodenal Ulcer / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies