Despite the meaningful achievements in modern diagnosis and farmacotherapy a problem of diseases which combine with each other still remains one of most complicated parts of therapy. In gastroenterology we could set for example combination GERD and pancreatitis. In this case pancreatitis
is more severe and more often than not has a number of complications. This article includes the
information about circumstances of pathogenesis and treatment such kind of patients. It has been
regarded specialy the aspects of treatment of abdominal pain syndrome using secretolytic and enzymatic therapy.

GERD, pancreatitis, abdominal pain syndrome.

Baranov, S. A. Some of the Main Mechanisms of Pathogenesis of Chronic Pancreatitis in Cholelithiasis / S. A. Baranov // Klin. Med. - 1988. - Vol. 66, No. 6. - Pp. 26 - 29.

Boger, M. M. Pancreatitis / M. M. Boger. - Novosibirsk: Nauka, 1984. - 198 p. Vasiliev, Yu. V. Gastroesophageal Reflux Disease Combined with Chronic Pancreatitis and Peptic Ulcer / Yu. V. Vasiliev, A. A. Masharova, O. B. Yanova // Clinical, Epidemiological and Ethno-Ecological Problems of Diseases of the Digestive Organs. — Krasnoyarsk, 2005. — P. 18–19.

Grinevich, V. B. Clinical and pharmacoeconomic aspects of polyenzyme replacement therapy / V. B. Grinevich, I. V. Bogdanov, O. A. Sablin // Clinical prospects of gastroenterology, hepatology. — 2004. — No. 2. — P. 16–23.

Grinevich, V. B. Clinical rationale for the use and efficacy of Nexium in the combination therapy of chronic pancreatitis / V. B. Grinevich, Yu. P. Uspensky, V. P. Lasy, et al. // Gastroenterology.St. Petersburg. — 2002. — No. 1. — P. 20–22.

Gubergrits, N. B. Treatment of patients with chronic pancreatitis combined with gastroesophageal reflux disease / N. B. Gubergrits, N. A. Kryuk // Gastroenterol. SPb. — 2007 —No. 1–2. — P. 114.

Gubergrits, N. B. Clinical pancreatology / N. B. Gubergrits, T. N. Khristich. — Donetsk: Lebed, 2000. — 412 p.

Kalinin, A. V. Impaired cavity digestion and its drug correction / A. V. Kalinin // Clinical prospects gastroenterol., hepatol. — 2001. — No. 3. — P. 13–17.

Korotko, G. F. Pancreatic Secretion / G. F. Korotko. — Moscow: Triada-X, 2002.— 224 p.

Maev, I. V. Gastroesophageal Reflux Disease / I. V. Maev, E. S. Vyuchnova, M. I. Shchekina // The Attending Physician. — 2004. — No. 4. — P. 21–33.

Maev, I. V. Chronic Pancreatitis / I. V. Maev, A. N. Kazyulin, Yu. A. Kucheryavy. — Moscow: Meditsina, 2005.

Maev, I. V. Chronic Pancreatitis: (Diagnostic Algorithm and Treatment Tactics). A manual for general practitioners, therapists, and gastroenterologists: A textbook / I. V. Maev, A. N. Kazyulin, A. A. Samsonov, et al. — Moscow: State Educational Institution of Higher Education, Scientific Medical Center of the Ministry of Health and Social Development of the Russian Federation, 2006. — 104 p.

Minushkin, O. N. Chronic pancreatitis / O. N. Minushkin // Ter. arch. — 2001. — Vol. 73, No. 1. — Pp. 62–65.

Nesterenko, Yu. A. Chronic pancreatitis / Yu. A. Nesterenko. — Moscow: Mokeev, 2000. — Pp. 5–20.

Pakhomova, I. G. Clinical and psychosomatic characteristics and quality of life of patients with recurrent chronic pancreatitis combined with hypertension: author's abstract. Dis. … Cand. of Medicine / I. G. Pakhomova. - St. Petersburg, 2003. - 23 p.

Tkachenko, E. I. Therapy of exocrine pancreatic insufficiency in patients with chronic pancreatitis / E. I. Tkachenko, Yu. P. Uspensky, I. G. Pakhomova // Gastroenterology. Supplement to Consilium medicum. - 2006. - Vol. 8, No. 2. - P. 38 – 42.

Uspensky, Yu. P. The problem of combined pathology in the gastroenterology clinic: possibilities of overcoming polypharmacy / Yu. P. Uspensky // Gastroenterol. SPb. — 2005. — No. 3–4. — P. 33–36.

Uspensky, Yu. P. Abdominal pain syndrome in gastroenterological practice (problem analysis) / Yu. P. Uspensky, I. G. Pakhomova // Clinical prospects of gastroenterology, hepatology. — 2007. — No. 5. — P. 21–31.

Shifrin, O. S. Clinical use of the drug Mezim forte 10000 in the painful form of chronic pancreatitis / O. S. Shifrin, E. Yu. Yuryeva // Russ. journal of gastroenterology, hepatology, coloproctology. — 2004. — No. 5. — P. 54–58.

Yakovenko, A. V. Clinical presentation, diagnosis, and treatment of chronic pancreatitis / A. V. Yakovenko // Klinich. med. — 2001. — Vol. 79, No. 9. — P. 15–20.

Buchler, M. W. Pancreas: Diseases / M. W. Buchler, W. Uhl, P. Malferstheiner. — Karger, 2004. — 186 p.

Ihse, I. Pancreatic pain: Is there a medical alternative to surgery? / I. Ihse, R. Andersson, J. Axelson // Digesti. — 1993. — Vol. 54, Suppl. 2. - P. 30 – 34.

Johnsson, F. One week omeprazole treatment in the diagnosis of gastro-oesophageal reflux disease / F. Johnsson, L. Weywadt, J. H. Solhaug et al. // Scand. J. Gastroenterol. — 1998. - Vol. 33. - P. 15 – 20.

Malesci, A. No effect of long term treatment with pancreatic extract on recurrent abdominal pain in patient with chronic pancreatic / A. Malesci, E. Gala et al. // Scand. J. Gastroenterol. - 1995. - Vol. 30. - P. 392.

Pulverer, G. Mikroflora-associated defense stimulating factors / G. Pulverer, H. Lioe Ko, J. Beuth // Scand. J. Gastroenterol. - 1997. - Vol. 32, Suppl. 222. - P. 107 – 111.

Ramo, D. J. Self-administration of enzyme substitution in the treatment of exocrian pancreatic insufficiency / D. J. Ramo et al. // Scand. J. Gastroenterol. - 1989. - Vol. 24. - P. 688.

Slaff, J. I. Protease-specific suppression of pancreatic exocrine secretion / J. I. Slaff, D. Jacobson et al. // Gastroenterology. - 1984. - Vol. 87. - P. 44.

Treatment of pain in chronic pancreatitis: AGA Medical Position Statement // Gastroenterology. - 1998. - Vol. 115. - P. 763 – 764.