Zollinger-Ellison Syndrome

Zollinger-Ellison syndrome (ZES) triad

• Markedly elevated gastric acid secretion

• Peptic ulcer disease

• A gastrinoma or non-β islet cell tumor of the pancreas or duodenal wall that produce...

Abdominal pain is the most common symptom (80%).

Diarrhea (postprandial and fasting) (70%)

Heartburn...

Goals are to control acid hypersecretion and resect the tumor.

Advanced imaging initially to evaluate for resection

Surgical removal when primary tumor can be identified and as...

Longitudinal follow-up to evaluate for metastases

Titrate medical therapy to control symptoms.

Advise patients of potential danger of stopping ant...

Hirschowitz BI, Fineberg N, Wilcox CM, et al. Costs and risks in the management of patients with gastric acid hypersecretion. J Clin Gastroenterol.  2010;44(1):28–33. [View Abs...

Consider ZES if peptic ulcers recur or if high doses of PPI are needed to control symptoms/ulcers.

~25–30% of cases of ZES occur in association with MEN1.

Once ZES is diagnosed, search f...