A 29 year old Hispanic male with history of DM type 1, Type V hyperlipoproteinemia, and chronic pancreatitis with exocrine insufficiency came to the ER complaining of abdominal pain. His abdominal pain had started 2 days ago, 6/10, periumbilical, radiated to the back, dull in nature, not related to food, intermittent at first, but was constant for the last 1 day. On review of systems, he complained of subjective fever, chills, diaphoresis, nausea, 2-3 episodes of non-bloody, non-bilious vomiting, loss of appetite, about 20 lbs wt loss over 3 months, and dark-colored stools. Pertinent findings on physical examination were no pallor or icterus, diffuse abdominal tenderness on palpation without rebound or guarding with good bowel sounds and no organomegaly, and digital rectal examination showed good anal sphincter with no gross blood. His significant laboratory findings were hemoglobin and hematocrit of 8.7/25.4 with lipase of 28. He was admitted to general medical floor for acute on chronic pancreatitis. He was aggressively treated with intravenous normal saline. In view of his anemia, esophagogastroduodenoscopy (EGD) was performed. EGD showed erythema antrum of the stomach and duodenitis and biopsy showed mild chronic inflammation in the gastric mucosa but no helicobacter pylori and no villous blunting in the duodenum. Subsequently, he was started on protonix 40mg po daily and iron supplements. Furthermore, his symptoms improved and he tolerated oral diet and was discharged home to follow-up in GI clinic. In the postprandial periods intraduodenal pH has been shown to be markedly reduced in chronic pancreatitis patients. Intragastric pH is also lower in chronic pancreatitis patients. When focusing on the percentage of postprandial time with pH below five in the duodenum and pH below three in the stomach, chronic pancreatitis patients were exposed to acid in stomach and duodenum for a significantly longer period. Several previous studies have measured intraduodenal pH in patients with chronic pancreatitis and all have observed an abnormally low intraduodenal pH with reduced acid neutralizing capacity.