Zollinger-Ellison Syndrome: Symptoms, Causes, Treatment
متلازمة زولينجر إليسون
Zollinger-Ellison syndrome results from a gastrin-secreting tumor that increases stomach acid. Recurrent ulcers or diarrhea may occur, requiring both acid control and tumor assessment.
What is Zollinger-Ellison Syndrome?
The tumors, called gastrinomas, usually arise in the duodenum or pancreas. Most heartburn and ulcers are not caused by this rare syndrome.
Related reading: Peptic ulcer disease and other causes.
Symptoms
Heartburn, upper abdominal pain, diarrhea or weight loss may occur. Recurrent or difficult-to-treat ulcers prompt investigation for less common causes.
Causes
Gastrinomas may occur independently or with multiple endocrine neoplasia type 1. Elevated gastrin alone has other explanations, including medicines.
Risk factors
MEN1 or a family history of it increases risk. Common acid-related symptoms usually have other explanations that clinicians assess first.
Diagnosis
Gastrin results must be interpreted alongside gastric acidity and medicines, followed by tumor-localizing tests. Do not independently stop acid suppression before testing; it may be essential protection.
Treatment
Specialist-prescribed proton pump inhibitors control acid. Surgery or other tumor treatment depends on location, spread and any hereditary syndrome.
Complications
Acid excess can cause bleeding, perforation or narrowing, and some tumors spread. Relief of heartburn does not eliminate the need for tumor follow-up.
Prevention
There is no established tumor prevention. Follow acid-suppression and surveillance plans and discuss genetic counseling when recommended from the clinical and family history.
When to see a doctor
Vomiting blood, black stools, sudden severe abdominal pain or fainting requires emergency care. Persistent diarrhea with dehydration or weight loss needs prompt review.