(Z-E Syndrome; Gastrinoma)
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- Family history
- Problems with the endocrine system
- Recurrent peptic ulcer disease
- Abdominal pain
- Nausea or vomiting
- Diarrhea (30%)
- Ulceration of stomach and small bowel
- Heartburn, difficulty swallowing (60%)
- Weight loss
- Oily stool
- GI bleeding with anemia, black stool, or bloody vomit
Gastrin stimulation tests
- Standard test meal
- Secretin ( a hormone)
- Looking for elevated gastrin levels in blood
Upper gastrointestinal endoscopy
- A thin instrument with a light and camera is inserted down the throat and into the stomach and intestine to look for ulcers
Surgical Removal of Tumor
Medications for Ulcers
- Proton pump inhibitors are medications that reduce acid by blocking the ‘pumps’ in acid-secreting cells. Examples include Nexium, Prevacid, Protonix, and Prilosec.
- Histamine blockers are medications to reduce the amount of hydrochloric acid released by the stomach. This will relieve pain and allow the ulcers to heal.
- Chemotherapy such as streptozocin is used in those with malignant form. with or without evidence of cancer spread.
- Control tumor growth with the use of somatostatin analogs (eg, octreotide).
American Gastroenterological Association http://www.gastro.org/
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/
The Canadian Association of Gastroenterology http://www.cag-acg.org/
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/
Berna MJ, Hoffmann KM, Long SH, et al. Serum gastrin in Zollinger-Ellison syndrome: II. Prospective study of gastrin provocative testing in 293 patients from the National institutes of Health and comparison with 537 cases from the literature, evaluation of diagnostic criteria, proposal of new criteria, and correlations with clinical and tumoral features. Medicine . 2006;85:331-64.
Campana D, Piscitelli L, Mazzotta E, et al. Zollinger-Ellison syndrome: diagnosis and therapy. Minerva Med. 2005;96:167-206.
DynaMed Editorial Team. Zollinger-Ellison syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated October 18, 2010. Accessed November 11, 2010.
Mayo Clinic. Zollinger-Ellison syndrome. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/zollinger-ellison-syndrome/DS00461 . Updated July 24, 2010. Accessed November 11, 2010.
Norton JA, Fraker DL, Alexander HR, et al. Surgery to cure the Zollinger-Ellison syndrome. N Engl J Med . 1999;341:635-644.
Norton JA, Jensen RT. Resolved and unresolved controversies in the surgical management of patients with Zollinger-Ellison Syndrome. Ann Surg . 2004;240:757-773.
Pellicano R, De Angelis C, Resegotti A, Rizzetto M. Zollinger-Ellison syndrome in 2006: concepts from a clinical point of view. Panminerva Med . 2006;48:33-40.
Tomassetti P, Salomone T, Migliori M, et al. Optimal treatment of Zollinger-Ellison syndrome and related conditions in elderly patients. Drgus Aging. 2003;20:1019-1034.
- Reviewer: Daus Mahnke, MD
- Review Date: 03/2013 -
- Update Date: 00/31/2013 -