Zollinger-Ellison Syndrome

Zollinger-Ellison syndrome is a rare disease that is associated with a particular tumor of the gastrointestinal tract. The disease is particularly dangerous because of frequent development of peptic ulcers.


The situation is related to excessive production of a hormone known as gastrin. There are many cells that produce this substance in our organism. Gastrin affects stomach cells to release gastric acid. So gastrin is responsible for correct acidity of the stomach. Sometimes, a tumor may grow from the gastrin-producing cells. This tumor is known as gastrinoma. Gastrinoma most commonly occurs in pancreas and duodenum, but it may grow even from other organs of the gastrointestinal tract. The gastrinoma cells may produce large quantities of gastrin.


Excessive gastrin concentration causes increased secretion of gastric acid and high stomach acidity resulting in higher incidence of peptic ulcers in stomach and duodenum. The symptoms include abdominal pain, gastrointestinal bleeding, loss of appetite, etc. (see the text about peptic ulcers). Increased level of gastrin is also related to higher intestinal peristalsis and diarrhea.


In a patient with suspected Zollinger-Ellison syndrome, it is possible to determine the serum level of gastrin, which should be abnormally increased. It is necessary to look for the source of gastrin, i.e. for the tumor. The tumor location may be found by computed tomography, magnetic resonance imaging or scintigraphy.


Increased secretion of hydrochloric acid is treated by drugs known as proton pump inhibitors. The actual tumor is treated surgically or by chemotherapy. Only total and successful destruction of the tumor mass leads to complete recovery of the patient. Prognosis of the disease depends on the particular characteristics of the tumor. Aggressive malignant gastrinomas can form metastases and significantly worse prognosis than benign gastrinomas.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources