Zollinger Ellison Syndrome

By Refadoc, Posted on : Tuesday, 15 September 2015 - 10:46 am IST

Zollinger- Ellison Syndrome: Basic Overview

Zollinger-Ellison Syndrome is a very complex condition which leads to the creation of either one or many tumours inside the pancreas and the upper part of the small intestine or the duodenum. These tumours are also known as gastrinomas. The tumours secrete very large amounts of gastrin, the hormone which causes the stomach to secrete the digestive acids. An excessive amount of acid can lead to the formation of peptic ulcers.

Though Zollinger-Ellison Syndrome is very rare, it can occur in people of various age groups. However, this condition is very common between the age group of 30 to 50 years. Medications are used extensively in order to treat the ulcers caused due to Zollinger Ellison Syndrome. 

Zollinger Ellison Syndrome: Causes

The exact reason for the occurrence of Zollinger Ellison Syndrome is unknown. The syndrome tends to begin with the formation of a tumour or a gastrinoma near the pancreas, duodenum as well as the lymph nodes around the pancreas.

The Pancreas is a gland which is situated below the stomach. They are responsible for secreting enzymes which help in the digestion of the food. The pancreas secretes hormones such as gastrin, which controls the production of the digestive juices. Due to the tumours which are caused by the Zollinger Ellison Syndrome, large amounts of gastrin are secreted which leads to an excessive amount of acid production. This leads to causing peptic ulcers and diarrhoea in many cases. Apart from secreting an excessive amount of acid, the tumours can also be malignant in nature and can spread to the other organs, especially the lymph nodes and the liver.

Signs and Symptoms of Zollinger Ellison Syndrome:

The following are the major signs and symptoms of Zollinger Ellison Syndrome:

  •       Pain in the abdomen
  •       Diarrhoea
  •       Burning and aching sensation in the abdomen
  •       Acid reflux and heartburn
  •       Nausea and vomiting
  •       Excessive weakness
  •       Loss of body weight
  •       Loss of appetite
  •       Anaemia

It is recommended to check in with a doctor if you have been having the above mentioned signs and symptoms. Early detection and treatment is very important in case of Zollinger Ellison Syndrome. 

Tests and Diagnosis of Zollinger Ellison Syndrome:

The following tests are used in order to diagnose the condition:

  1. Medical History: The first step towards the diagnosis of the condition is to go in for the review of the patient’s medical history. If the patient has a sibling or a parent with the MEN I, they are at an increased risk of suffering from the condition.
  2. Blood Tests: In this, a sample of the patient’s blood is tested in order to check the levels of gastrin. The patient is required to fast before the test as the gastrin levels tend to fluctuate.
  3. Gastrin Level Measurement: Elevation of the gastrin level occurs due to Zollinger Ellison syndrome. The doctors test the levels of Gastrin with the help of the secretion stimulation test. This test measures the level of gastrin in the bloodstream.
  4. Imaging Tests: These tests make use of CT and MRI Scans in order to obtain the images of the tumours.
  5. Endoscopic Ultrasound: Through this test, the doctor examines the stomach and the duodenum of the patient with the help of an endoscope. This test makes it very easy for the doctor to inspect the digestive system. Also, a biopsy can be done with the help of endoscopy. The patient needs to fast before this test. 

Treatment and Drugs for Zollinger Ellison Syndrome:

In order to treat the Zollinger Ellison Syndrome, the doctor tends to treat the tumours as well as the ulcers. The tumours need to be removed so that there is no further requirement of the treatment.

Surgical operations can be done in order to remove the tumours which are small in size and are difficult to locate. If a single tumour is there, it can be easily removed with the help of a surgery. In case of multiple tumours, the doctors may recommend the following procedures:

  •       Debulking: Removal of the liver tumour
  •       Embolization: Destroying the cancer by cutting off the blood supply
  •       Injecting drugs in order to relieve the symptoms
  •       Use of chemotherapy in order to slow down the progression of the disease
  •       Liver transplantation

Medications are easily available in order to decrease down the production of excessive acid. Drugs such as Omeprazole, Pantoprazole and Rabeprazol are very effective in decreasing the excessive amount of acid. The drugs and surgery is used in order to stop the growth and bleeding of the ulcer and relieves the obstruction which has been caused due to an ulcer. 

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