Zollinger-Ellison Syndrome, a rare disease, causes pancreatic or upper small intestine tumors. Gastrinomas are the name for these growths. These tumors, called gastrinomas, secrete an abundance of the hormone gastrin. Peptic ulcers are brought on by gastrin, which causes the stomach to overproduce acid. Symptoms including diarrhea, abdominal pain, and others have been linked to high gastrin levels.Thank you for reading this post, don't forget to subscribe!
The onset of Zollinger-Ellison syndrome is not age-specific. Nonetheless, diagnosis typically occurs between the ages of 20 and 60. Standard treatment for stomach ulcers entails taking medication to reduce acid production in the stomach and promote the healing of any existing sores. Tumor removal surgery may be necessary for some patients.
Symptoms of Zollinger-Ellison Syndrome
The following are some of the possible symptoms of Zollinger-Ellison syndrome:
- Abdominal discomfort.
- Pain, discomfort, or a burning sensation in the upper abdomen.
- Heartburn and acid indigestion.
- Nausea and vomiting.
- Gastrointestinal bleeding.
- Unintentional weight loss
- A decrease in hunger is a common side effect.
Reasons to See the Doctor
Constant nausea, vomiting, and diarrhea along with a burning or agonizing discomfort in the upper abdomen should prompt a visit to the doctor.
If you have been taking over-the-counter medications to decrease stomach acid, you should let your doctor know. Drugs like Prilosec, Zegerid, and Tagamet HB’s omeprazole and famotidine are examples (Pepcid AC). In addition to masking symptoms, these drugs may also obscure an accurate diagnosis.
Causes of Zollinger-Ellison Syndrome
No one knows for sure what triggers Zollinger-Ellison syndrome. Nonetheless, Zollinger-Ellison syndrome often follows a consistent series of occurrences. If you have a tumor in your pancreas or your duodenum, you have this syndrome. The duodenum is the portion of your digestive system that links to your stomach. It is also known as the “small intestine.” Tumors can sometimes develop in unusual locations, such as the lymph nodes close to your pancreas.
Both behind the stomach and behind the diaphragm is where you’ll find the pancreas. Enzymes produced by it aid in the breakdown of food. The pancreas produces insulin and other hormones. Insulin controls blood sugar.
The pancreas, liver, and gallbladder all contribute to the digestive process, and their juices combine in the duodenum. The majority of your digestive process takes place here.
Zollinger-Ellison tumors have cells that produce an abundance of the hormone gastrin. Thus, they are occasionally called gastrinomas to reflect this fact. When gastrin levels are up, the stomach produces an abnormally high amount of acid. If stomach acid levels become too high, you may experience peptic ulcers and even diarrhea.
Tumors are not only malignant but also cause an increase in acid production. Even though these tumors develop slowly, the cancer can spread to other organs, most frequently the liver or lymph nodes in the area.
Connected to MEN 1
Multiple endocrine neoplasia type 1 (MEN1) is a potential hereditary etiology of Zollinger-Ellison syndrome (MEN 1). Parathyroid tumors are also common in people with MEN 1. Likewise, their pituitary glands could be afflicted with malignancies.
25% of patients with gastrinomas have them as part of MEN 1. Tumors of the pancreas and maybe other organs are also possible in this population.
Risk (Indicators of Danger)
Zollinger-Ellison syndrome is more common in people who have a first-degree relative with MEN 1, such as a sibling or parent.
Diagnosis of Zollinger-Ellison Syndrome
Your doctor will likely use the following to make a diagnosis:
Previous health records. Your doctor will inquire as to how you’re feeling and will examine your medical records.
This includes blood tests. Blood samples can reveal high gastrin levels. Elevated gastrin levels can indicate pancreatic or duodenal cancers, but they can also indicate other disorders. Gastrin levels may rise if your stomach doesn’t produce acid or you’ve had gastric surgery. Using medication to reduce stomach acid can potentially increase gastrin production.
For this examination, fasting is required. It’s possible you’ll also need to stop taking your acid reflux medication. Due to gastrin fluctuation, test results may require repeating.
A secretin stimulation test may also be administered.
A hormone called secretin controls the amount of acid produced by the stomach. First, your healthcare professional will determine your gastrin levels. The next step is to inject you with secretin. This time, your gastrin levels will be evaluated. Increases in gastrin are characteristic of Zollinger-Ellison syndrome.
Endoscopy of the esophagus, stomach, and intestines.
Sedation is necessary for this exam. It is possible to examine the gastrointestinal tract, including the stomach and duodenum, with an endoscope by inserting a thin, flexible probe down the patient’s throat. Endoscope is the name for this piece of equipment. At the tip, you’ll find both a light and a camera. Providers can examine you for ulcers with this tool.
Tissue samples could be taken when doing the endoscopy.
A biopsy is the medical term for this procedure. Gastrin-secreting tissue will be testing for cancer.
Endoscopies also evaluate stomach acid production. High gastrin and stomach acid levels indicate Zollinger-Ellison syndrome. After midnight on the night before the exam, you must observe a fast.
Ultrasound imaging of the digestive tract was perform endoscopically. The endoscope is use in this surgery alongside an ultrasound probe. Cancers of the stomach, duodenum, and pancreatic can be more easily detecting with the help of the probe.
A tissue sample may be taken from you by your doctor using an endoscope. Similar to the previous test, this one calls for a midnight fast and sedation.
Include diagnostic imaging procedures.
Imaging technology can help your doctor detect cancers. Somatostatin receptor scintigraphy is one example of a nuclear imaging test. The tumors can be located with the use of radioactive tracers in this test. Ultrasound, CT, MRI, and Ga-DOPA TATE PET-CT scanning are also use imaging tests.
Treatment of Zollinger-Ellison Syndrome
The ulcers caused by hormone-secreting tumors in patients with Zollinger-Ellison syndrome are a primary focus of treatment.
Due to their size and location, gastrinoma tumors are often difficult to locate and remove surgically. It’s possible that surgical removal of a single tumor is an option if you and your doctor have discussed it. But, if you have a large number of tumors or if the tumors have progressed to the liver, surgery may not be an option. However, your surgeon may suggest removing a single large tumor even if you have numerous smaller ones.
Providers may also suggest the following treatments in order to slow tumor growth:
- Debulking, the process of removing as much of a liver tumor as possible.
- Embolizing the blood vessels feeds the tumor in an effort to eliminate them.
- In radiofrequency ablation, heat is used to kill cancer cells.
- Treatment of cancer symptoms by injecting medications directly into a tumor.
- Attempting to inhibit tumor development by means of chemotherapy.
- Alive after liver transplantation
Acid overdose treatment
In most cases, limiting acid production will solve the problem. Proton pump inhibitors are the initial medication prescribing. In patients with Zollinger-Ellison syndrome, these medications are helpful in reducing acid production.
Acid-reducing medications such as proton pump inhibitors are extremely effective. Their effectiveness comes from their ability to stop acid-secreting cells’ microscopic “pumps” from doing their thing. Prevacid, Prilosec, Zegerid, Protonix, Aciphex, and esomeprazole are commonly prescrib for acid reflux (Nexium).
An increasing incidence of hip, wrist, and spinal fractures has been link to the long-term usage of prescription proton pump inhibitors. Those above the age of 50 have a significantly increased threat. Acid-blocking has a small risk, but the advantages outweigh it.
Some patients may benefit from taking octreotide (Sandostatin), a drug that acts similarly to the hormone somatostatin.