Causative & risk factors
The exact cause of Zollinger Ellison syndrome is not known.
It is said to be associated with multiple endocrine neoplasia, type I (MEN I)
Clinical presentation
Persons with Zollinger-Ellison syndrome may remain asymptomatic. Most of the time, the symptoms of peptic ulcer mask the symptoms of Zollinger-Ellison syndrome. Gastro-intestinal disturbances such as nausea, vomiting, burning in the abdomen and diarrhea are usually seen. There may be bleeding in the gastro-intestinal tract. Additional symptoms include fatigue, loss of appetite and loss of weight.
Investigations
A blood test will demonstrate elevated levels of gastrin. An ultrasound, CT or MRI scan of the abdomen is carried out to visualize the tumors. An endoscopic examination of the gastro-intestinal tract is carried out to visualize the ulcers. A biopsy of the ulcer can be carried out at the same time.
Treatment
Medications like proton pump inhibitors and H2 receptors are used to reduce acid secretion and to allow the ulcer to heal. Surgery can be performed to remove the tumor. If the tumor is malignant, radiation and chemotherapy is indicated.
