[Impact of hydrochloric acid and HP-invasion on the cavitary pressure in the duodenal and gastroesophageal region in patients with ulcer].

The goal of the study was to examine the cavitary pressure (P) in the duodenal and gastroesophageal region under the impact of acidification of the duodenum (D) and depending on the hydrochloric acid gastric secretion (HCL) and Helicobacter pylori (HP) infection in patients with ulcer. Endoscopic manometrography performed in 205 patients (with duodenal ulcer, gastric ulcer and chronic gastritis) revealed a considerable (p<0.05) increase in P (mmHg) in the D (9.4 +/- 0.4 vs. 11.8 +/- 1.0) and in the antral region of the stomach (ARS) (9.6 +/- 0.3 vs. 11.4 +/- 0.6), decreased pylorus tone (33.9 +/- 4.6 vs. 17.5 +/- 6.0) and pressure gradients (AP) between the low esophageal sphincter (LES) and D (6.6 +/- 0.4 vs. 3.9 +/- 1.3) in patients with increased basal acid secretion (BAS (BAS > 10 mm/hour vs. BAS < 7 mm/per hour). Acid infusion of 0.1N HCL in 39 patients was accompanied by the increase of P in the D (from 9.7 +/- 1.1 to 13.1 +/- 1.2), ARS (from 8.6 +/- 1.3 to 12.8 +/- 1.4) and tendency to the reduction in the P in the pylorus (from 28.2 +/- 2.5 to 20.6 +/- 3.6) as well as feeling of pain in all patients with active duodenal ulcers. The presence of HP in 47 out of 87 patients as compared to its absence was associated with the increased deltaP in the D-ARS (-0.6 +/- 0.43 vs. 2.1 +/- 1.1) and reduced deltaP in the LES-D (8.3 +/- 1.6 vs. 3.4 +/- 1.5) and deltaP LES-ARS (14.3 +/- 1.3 vs. 9.8 +/- 1.2) as well as more marked esophagitis (0.64 +/- 0.09 vs. 0.38 +/- 0.11 conventional units, p < 0.05). HP and hypersecreation of HCL synergistically or additively increase the antroduodenal tonic tension, promote the LES incompetence and further damage of the esophageal mucous coat.