Zollinger-Ellison Syndrome (Gastrinoma)
Zollinger-Ellison syndrome is a rare digestive
disorder caused by a tumor of the pancreas called gastrinoma.
Symptoms of Gastrinoma
The symptoms of Zollinger-Ellison syndrome are:
- Chronic diarrhea
Recurrent diarrhea is the only symptom of this condition in
about 30% of patients. This symptom may also precede the development
of Zollinger-Ellison syndrome by several years.
- Pain in the stomach and esophagus, especially at night or
between meals.
This pain may go away or worsen with eating.
- Heartburn or pain in the chest and upper abdomen
- Nausea
- Vomiting of blood, mucus, coffee-ground like vomit (digested
blood)
- Difficulty in swallowing
- Sore throat, coughing, and wheezing
- Sour or bitter taste in the mouth
- Blood in the stool
- Black, tar-like or deep-red colored stool
- Steatorrhea, or froty, oily stool with particularly
bad odor (evidence of malabsorption of nutrients)
- Malnourishment
How Is It Diagnosed?
Your doctor would perform the following tests to diagnose Zollinger-Ellison
syndrome:
- Endoscopy
A flexible tube with camera mounted at the end, called an endoscope,
is inserted through the esophagus, stomach, and small intestine.
Persistent and chronic ulcer, or an ulcer at a rare location
such as the end of the small intestine may be signs of this
condition.
- Stomach acid test
Elevated levels of acid in the stomach is a sign of this condition.
- Blood test
Elevated levels of the hormone gastrin in the blood is a sign
of Zollinger-Ellison syndrome.
In a test called secretin stimulation test,
an injection of the hormone secretin is performed
before the blood test to check the level of gastrin.
The location of the tumor is identified by the following tests:
- Computed Tomography or CT Scan
- Magnetic Resonance Imaging or MRI
Causes of Zollinger-Ellison syndrome?
Zollinger-Ellison syndrome is caused by a tumor (or tumors) called
gastrinoma that affects commonly the pancreas.
In rare cases, this tumor is also found in the stomach, liver,
small intestine, and ovaries. The tumor produces a high amount
of the hormone gastrin, which cause over-production
of stomach acid.
It is though that there is a strong genetic component to this
condition. People with a history of chronic peptic ulcer or cancer
of the pituitary glands and parathyroid are at increased risk
of developing this disease.
Zollinger-Ellison syndrome may also be a part of a larger condition
called multiple endocrine neoplasia-I, an inherited
form of cancer with tumors not only in the digestive tract, but
also the pituitary glands and parathyroid.
Treatment for Zollinger-Ellison syndrome?
The treatments for this condition include:
- Medications
Prescription medicines, such as proton pump inhibitors that
stop the production of stomach acid can treat the symptoms of
Zollinger-Ellison syndrome.
- Chemotherapy
- Surgery
Elimination of the tumor may require the removal of part of
the stomach, intestines, pancreas, and liver. In very rare cases,
total stomach removal or gastrectomy may be
necessary, although in most cases, prescription proton pump
inhibitors are sufficient.
