Zollinger-Ellison Syndrome |
Overview Zollinger-Ellison syndrome (ZES) is a rare disorder that causes tumours in the pancreas and duodenum (the first part of the small intestine) as well as ulcers in the stomach and duodenum. Causes ZES produces enzymes that break down fat protein and carbohydrates from food and hormones like insulin that break down sugar. The resulting tumours secrete a hormone called gastrin that causes the stomach to produce too much acid which in turn causes stomach and duodenal ulcers (peptic ulcers). The ulcers caused by ZES are less responsive to treatment than ordinary peptic ulcers. What causes people with ZES to develop tumours is unknown but approximately 25 percent of ZES cases are associated with a genetic disorder called multiple endocrine neoplasia type 1 which is associated with additional disorders. Symptoms A gnawing burning pain in the abdomen is the most common symptom present in 75% of those with ZEZ. Other symptoms may include:
Your doctor can diagnose ZES through blood tests to measure levels of gastrin and gastric acid secretion. Doctors can also check for ulcers by doing an endoscopy which involves looking at the lining of the stomach and duodenum through a lighted tube. Treatment The primary treatment for ZES is medication to reduce the production of stomach acid. Proton pump inhibitors that suppress acid production and promote healing are the first line of treatment and include drugs such as lansoprazole omeprazole pantoprazole and rabeprazole. H-2 blockers such as cimetidine famotidine and ranitidine may also be used but are less effective in reducing stomach acid. Other treatment options include surgery to treat peptic ulcers or to remove tumours in the pancreas or duodenum. People who have been treated for ZES should be monitored in case the ulcers or tumours recur. |