What is the treatment for Zollinger Ellison Syndrome?

Zollinger ellison syndrome (ZES) is a rare disorder characterized by one or more tumours in the pancreas, duodenum, or both. The tumours cause the stomach to make too much acid, leading to peptic ulcers in the duodenum. The tumours are sometimes cancerous and spread to other areas of the body.

The person suffering from the syndrome may experience the symptoms such as pain in the abdomen, diarrhoea, burning sensation or aching in the upper part of the abdomen, nausea, vomiting, fatigue, unusual weight loss, appetite loss and anaemia.

Treatment options

Finding and removing all gastrinomas is often challenging. Zollinger ellison syndrome is treated with medications to relieve ulcer symptoms and surgery, if appropriate, to remove tumours. A class of drugs called proton pump inhibitors effectively reduces gastric acid secretion in the stomach and includes

• esomeprazole (Nexium)
• lansoprazole (Prevacid)
• pantoprazole (Protonix)
• omeprazole (Prilosec)

Reducing stomach acid allows peptic ulcers to heal and relieves ZES symptoms. Some gastrinomas behave like cancers and spread to other parts of the body, especially the liver and bones.

In some cases, a patient may need surgery for the peptic ulcer or to remove the gastrinoma. For malignant tumours, radiation and chemotherapy may be offered.  Gastrinomas that cannot be surgically removed are sometimes treated with chemotherapy drugs, including:

• streptozotocin (Zanosar)
• 5-fluorouracil (Adrucil)
• doxorubicin (Doxil)

Prognosis

The outcome for people with zollinger ellison syndrome largely depends on the nature and extent of the gastrinomas (about one-fourth are considered cancerous). In most patients, peptic ulcer symptoms are well controlled, however, most patients—even those with tumours that spread.

If you have been treated for zollinger ellison syndrome (ZES), you should see your doctor on a regular basis to determine if the gastrinomas recur.

Read more articles on Zollinger Ellison Syndrome.