Zollinger-Ellison syndrome

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Zollinger-Ellison syndrome is a complex disease characterized by the presence of one or more tumors of the pancreas, upper small intestine (duodenum) or lymphatic nodes adjacent to the pancreas.

These tumors secrete large amounts of gastrin that causes excessive increase of the amount of stomach acid. Zollinger-Ellison syndrome is a relatively rare disease. The condition can occur at any time of life, especially around the age of 20-50 years, being slightly more common in men.

Treatment of Zollinger-Ellison syndrome consists mostly in medicines to reduce stomach acid and heal ulcers. Surgery to remove tumors may be an option for some people with Zollinger-Ellison syndrome.


1. Overview
2. Causes
3. Investigations


The exact cause of the disease remains unknown, but the sequence of specific disease onset is very well shaped. Syndrome will be present when a tumor or more will be formed in the pancreas, duodenum, or lymph nodes adjacent to the pancreas.

The pancreas is an organ located behind and below the stomach. It produces enzymes essential for digestion of food, and hormones (gastrin) that controls the production of stomach acid.

Tumors that occur in Zollinger-Ellison disease are composed of cells that secrete large amounts of gastrin that stimulates the stomach to produce more acid. Excess stomach acid can lead to the formation of gastric ulcers and sometimes diarrhea.


For Zollinger-Ellison syndrome diagnose the doctor will take into account:

- Patient’s medical history – He will want to know more about the signs and symptoms and review of patient medical history. If you have a blood relative suffering of MEN I, there is a higher probability that you to develop the same disease.

- Blood tests – Blood samples will be analyzed in the laboratory to detect if gastrin level is high. Elevated gastrin may indicate tumors in the pancreas and duodenum, but may be caused by other conditions.

Before this investigation the patient will not eat and stop taking any drugs used to reduce the amount of stomach acid, to measure as accurately his gastrin level.

- Measurement of gastrin levels – high levels of gastrin can be caused by conditions other than Zollinger-Ellison syndrome. The physician will test the degree of acidity of the stomach to indicate how high is the level of gastrin.

If the stomach is producing large amounts of acid, your doctor, ask for secretin stimulation test. In this investigation, the doctor will measure levels of gastrin, will be an injection of secretin and gastrin levels will be measured again. If the patient has Zollinger-Ellison syndrome, gastrin levels will increase even more.

- Upper gastrointestinal endoscopy

- Imagistic studies – The doctor may use imagistic techniques such as nuclear scan that uses radioactive substances to help locate tumors, computed tomography (CT) imaging with ultrasound or MRI.

- Endoscopic ultrasound – In this procedure, the doctor will examine the stomach and duodenum with an endoscope to take an ultrasound probe.



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