Zollinger Ellison Syndrome

Definition

Zollinger Ellison syndrome is the tumor in upper part of the small intestine or pancreas that secretes hormones which result in more secretion of gastric acid. This ultimately results in peptic ulcers.

Alternative names

Causes, incidence and risk factors

There is formation of tumor/s in the duodenum or pancreas. Theses tumors are made up of gastrin secreting cells. The excessive amount of gastrin secreted by tumor cells induces excessive secretion of gastric acid. The large amount of gastric acid can cause peptic ulcers or diarrhea.

Symptoms

Symptoms of Zollingre Ellison syndrome are similar to the peptic ulcer disease. There may be nausea, vomiting, rarely blood in vomit, burning, aching, upper abdominal discomfort, heartburn, stomach ulcers, ulcers in small bowel, weakness, unintentional weight loss and intestinal bleeding.

Sighs and tests

The condition is diagnosed on the basis of symptoms, medical history and diagnostic tests. The diagnostic tests include blood test (to check for gastrin levels); upper gastrointestinal endoscopy; imaging studies like CT (Computerized Tomography) scan, MRI (Magnetic Resonance Imaging) or ultrasound imaging; endoscopic ultrasound; calcium infusion test; exploratory surgery; octreotide scan or secretin stimulating test.

Treatment

Surgery can be done to remove the tumor. Practically it is not possible to remove all the tumors as many of them are too small. In such cases only a single large tumor may be removed. To control tumor growth removal of maximum possible number of liver tumors, liver transplant, cutting blood supply of the tumor, injecting drugs in the tumor or chemotherapy are the treatment options.

To control the production of excess acid proton pump inhibitors are used. The less potent histamine H2 receptor antagonists do not work to control acid secretion in Zollinger Ellison syndrome. The proton pump inhibitors are omeprazole, pentaprazole, rabeprazole, lanzoprazole ans esomeprazole magnesium.

Surgery may be done to treat peptic ulcers.

Expectations (Prognosis)

Cure rate of Zollinger Ellison syndrome is very low but the tumors grow very slowly so patient generally lives for longer time even after the detection of tumor. Acid suppressants are effective in controlling excess acid production.

Complications

The growth of the tumors may be slow but they may be cancerous and may spread to liver or nearby lymph nodes. There may be multiple tumors in the endocrine system, parathyroid gland and pituitary gland along with pancreas and duodenum (multiple endocrine neoplasia).

Severe diarrhea, weight loss, intestinal bleeding, intestinal perforation (hole) or spread of tumor to other organs are some more complications of Zollinger Ellison syndrome.

Calling your health care provide

If there are symptoms of peptic ulcer disease especially accompanied by diarrhea then one must get diagnosed soon. Over the counter anti-acid drugs should not be taken for longer duration. They may cover the illness and delay the diagnosis.

Prevention

There are no known measures of prevention of Zollinger Ellison Syndrome.

Reference

Nih.gov, mayoclinic.com