Zollinger-Ellison syndrome (or ZES) is condition characterized by the presence of a tumor or tumors called gastrinomas in the pancreas, duodenum (upper part of the small intestine) and lymph nodes near the pancreas. Tumors characteristic for this condition secrete hormone gastrin and thus provoke the stomach to produce more stomach acid. As a result of too much stomach acid, patients develop stomach ulcers.
ZES is a rare condition which usually affects adult people, mostly men. Patients suffering from ZES may experience symptoms very similar to those caused by peptic ulcers, such as abdominal pain, burning and ache in the upper abdomen, nausea, vomiting, diarrhea and heartburn. Many of them could suffer from lack of appetite, weakness, unexpected weight loss, anemia and bleeding in the digestive tract.
Any combination of these symptoms should be reported to your doctor in order for him/her to check if you have this syndrome. Certain medications, such as Omeprazole, ranitidine, famotidine or cimetidine may mask some of ZES symptoms. This may be very important, since ZES needs to be diagnosed and treated as soon as possible.
Causes and Prevention
Doctors have not been able to identify the exact cause of Zollinger-Ellison syndrome yet. However, they know what happens as a result of the syndrome. This condition starts as a gastrinoma (tumor) in the pancreas, lymph nodes near pancreas or in the duodenum. The tumor secretes large amounts of gastrin and this hormone affects and increases secretion of stomach acid, causing peptic ulcers and other problems.
In some cases ZES is associated with inherited condition, known as MEN I (multiple endocrine neoplasia, type 1) and such patients have several tumors in the endocrine system and parathyroid and/or pituitary gland.
At this moment, there are no ways to prevent ZES. There is some genetic testing, available for patients who know that there is a family history of serious peptic ulcers or gastrointestinal tumors. These tests cannot prevent Zollinger-Ellison syndrome, but can inform patients more about their health.
Patients suffering from ZES need to be treated for both, peptic ulcers and tumors. If tumors can be removed surgically, patient may not need ulcer treatment anymore.
Surgical removal or debulking of the tumor, embolization or radiofrequency ablation are the most common treatments for ZES tumors. Doctors may also recommend chemotherapy to slow the growth of these tumors or some injection drugs to relieve some of the symptoms.
Excess production of stomach acid can be treated with proton pump inhibitor medications such as pantoprazole, esomeprazole, lansoprazole, Omeprazole or rabeprazole. Surgical procedures may be used to treat bleeding ulcers, close the hole in the wall of the stomach or duodenum caused by the ulcer or relieve some obstruction caused by the ulcer.