Reflections about acid suppression therapy: choosing the optimal proton pump inhibitor, or the Captain’s Saga. Clinical case

The author presented a clinical case of the combined course gastric ulcer, gastroesophageal reflux disease against background significant increase in fecal calprotectin level absence endoscopic, histological confirmation Crohn’s disease.Multiple erosive and ulcerative lesions upper gastrointestinal tract may result from various reasons, one possible explanations be common form disease. A 32‑year‑old patient independently applied for consultation with complaints «chill» throat, some heaviness stomach after eating. endoscopic examination revealed signs esophagitis, multiple duodenum negative urease test, as well as, presumably, healed solitary rectal ulcer. Gastrinoma neuroendocrine tumor were excluded. 10‑fold has been revealed. results polypositional biopsies esophagus, stomach, duodenum, large intestine, rectum did not reveal process, inflammatory bowel diseases. parts digestive tube, associated Helicobacter pylori, cicatricial changes have found. Acid‑suppressive therapy dexlansoprazole promoted repair esophageal mucosa without positive effect on stomach. Replacement proton pump inhibitor administration pantoprazole combination bismuth was accompanied by complete healing all decrease calprotectin.