Zollinger-Ellison Syndrome Definition, Reason, Symptoms, Treatment & Prevention
Definition
Zollinger-Ellison syndrome is a rare disease in which one or more tumors form in the pancreas or upper small intestine. These tumors, known as gastrinomas, secrete large amounts of the hormone gastrin, which then increases stomach acid production. Excessive stomach acid production can cause stomach ulcers, diarrhea, and various other complaints.
Zollinger-Ellison syndrome is a rare disease. Generally, this syndrome is diagnosed when a person is between the ages of 20–50 years. Treatment for this disease generally includes medication to reduce stomach acid and relieve stomach ulcers.
Zollinger-Ellison Syndrome Symptom
Signs and symptoms of Zollinger-Ellison syndrome that are usually complained of can include:
- Abdominal pain
- Diarrhea
- Burning, pain, or discomfort in the upper abdomen
- Reflux (backflow) of stomach acid
- Nausea and vomiting
- Gastrointestinal bleeding
- Unintentional weight loss
- Decreased appetite
Zollinger-Ellison Syndrome Reason
The cause of Zollinger-Ellison syndrome is not known with certainty. However, the flow of the process of the occurrence of this disease has been widely studied by experts.
This syndrome begins when a tumor called a gastrinoma forms in the pancreas, upper small intestine, or lymph nodes that are located around the pancreas. The tumor is formed from cells that produce large amounts of the hormone gastrin, which causes an increase in stomach acid production.
This then causes the formation of ulcers in the stomach and sometimes also causes diarrhea. Apart from causing excess stomach acid production, this type of tumor is also a malignant tumor. Although the tumor growth is relatively slow, the tumor can still spread, especially to the lymph nodes in the liver.
Zollinger-Ellison syndrome is also associated with an inherited condition, known as multiple endocrine neoplasia type 1 (MEN 1). People with MEN 1 can also have tumors in other glands in the body, including the parathyroid and pituitary glands. In addition, individuals with family members who have MEN 1 also have a higher risk of experiencing Zollinger-Ellison syndrome.
Diagnosis
The diagnosis of Zollinger-Ellison syndrome can be determined by the following:
- Medical history. The doctor can ask about the signs and symptoms you are experiencing and review your previous medical history.
- Blood test. Blood sampling can be done to evaluate if there are elevated gastrin levels. Elevated gastrin levels can indeed be an indication of a tumor in the pancreas or small intestine.
However, this increase can also occur in other conditions. For example, in conditions when the stomach does not produce enough stomach acid, or in those who are taking stomach acid-lowering drugs.
- Upper gastrointestinal endoscopy. This examination uses a thin, flexible instrument that is inserted into the digestive tract through the mouth, to evaluate for stomach ulcers. This technique can also be used to take samples of stomach tissue, to detect gastrin-producing tumors.
- Endoscopic ultrasound (USG). This examination is performed to evaluate the stomach, small intestine, and pancreas with an endoscope that has ultrasound capabilities. Through this procedure, tumors in the upper digestive tract can be detected.
- Imaging. Doctors can perform imaging techniques such as somatostatin receptor scintigraphy. This is an examination that uses radioactive tracing to determine the location of the tumor.
Other imaging tests that may also be performed include ultrasonography (USG), computerized tomography (CT), and magnetic resonance imaging (MRI).
Zollinger-Ellison Syndrome Treatment
Treatment for Zollinger-Ellison syndrome includes medication to treat the tumor as well as to treat excess stomach acid.
One of the treatment options for treating tumors is surgery if the number of tumors is small. However, if the number of tumors is large or there are tumors that have spread to the liver, other treatment options need to be made.
Doctors can also suggest several treatment options to control tumor growth. These include removing the tumor as optimally as possible, trying to destroy the tumor by stopping blood flow to the tumor or using heat, injecting drugs into the tumor to treat cancer symptoms, using chemotherapy to slow tumor growth and liver transplants.
Treatment options for dealing with excess stomach acid include administering drugs to reduce stomach acid production, which work by inhibiting the ‘pump’ found in stomach cells that produce acid.
Prevention
Until now there has been no effective prevention of Zollinger-Ellison syndrome. This is because the cause of this syndrome is still not known with certainty until now.