What is Zollinger ellison syndrome?

In healthy individuals, enough stomach acid is produced by the stomach to digest and break down food that reaches the stomach after eating. The secretion of stomach acid is governed by gastrin, a type of hormone produced by the stomach. The acid produced is only in the amount to be used in the digestion of nutrients and is not at a level to damage the stomach wall or any organ in the further parts of the digestive tract. However, in some cases, the secretion pattern of the gastrin hormone changes and diseases associated with excessive acid production may occur. One of them is Zollinger Ellison Syndrome .

What is Zollinger ellison syndrome?
Zollinger Ellison Syndrome is a very rare form of disease in which more than one tumor occurs in the pancreas or small intestine. These tumors, called gastrinomas, release the hormone gastrin, causing the stomach to produce excessive amounts of acid. The high amount of acid produced in the stomach damages the digestive tract, causing the formation of ulcers in the later parts of the intestine, especially the duodenum, just like the damage to the stomach in peptic ulcer (stomach ulcer) disease. Tumors found in the pancreas or small intestine in Zollinger Ellison Syndrome can be benign or malignant. If tumors are malignant, this can be classified as a type of cancer and carries the risk of spread to different tissues and organs of the body. Zollinger Ellison Syndrome, a rare type of disease, occurs in only one in 1 million people. Although the disease can be seen in both female and male sexes and in all age groups, it has been determined that male individuals between the ages of 30-50 are more likely to get this disease. This disease, which is thought to be effective in genetic factors, requires early diagnosis and treatment, as it can cause great damage to the digestive tract.
What are the symptoms of Zollinger ellison syndrome?
The symptoms of the disease in Zollinger Ellison Syndrome patients show great similarity with peptic ulcer. The most common and most basic symptom of the disease is abdominal pain. This pain is a dull or flammable pain that can be felt anywhere between the navel area and the upper part of the abdomen that corresponds to the stomach. The pain in question is also the main symptom of peptic ulcer. Abdominal pain that patients feel is exacerbated, usually during fasting times when the stomach is empty, between meals or at night. Although the pain subsides a bit with eating, it usually does not disappear completely. The pain sometimes continues for minutes and sometimes for hours, making daily life very difficult. Apart from this, other symptoms seen in Zollinger Ellison Syndrome include:
Diarrhea
Gas outflow from the mouth (burping)
Nausea and vomiting
Bloating
Anorexia and weight loss
In addition to the above symptoms, some patients may develop gastroesophageal reflux. Gastroesophageal reflux is a problem of the stomach contents, also known as reflux disease, escaping into the esophagus. In patients with this problem, apart from the above symptoms, a burning sensation in the chest area and acidic gastric juice may come to the mouth. In some Zollinger Ellison Syndrome patients, diarrhea can be the only symptom.
What causes Zollinger ellison syndrome?
The exact cause of Zollinger Ellison syndrome is not yet known, but scientific research on this subject continues. Approximately 25-30% of tumors that occur in the pancreas or small intestine, also called gastrinomas, have been found to be due to a genetic disorder called multiple endocrine neoplasia (MEN1). This is an important evidence that genetic factors play an important role in the occurrence of the disease. Individuals with a family history of Zollinger Ellison Syndrome are more likely to get this disease than others. The genetic disorder in question is also associated with diabetes (diabetes) disease, kidney stones, bone weakness and fracture, muscle weakness, and hormonal disorders.
How is Zollinger ellison syndrome diagnosed?
Zollinger Ellison Syndrome patients refer to health institutions with the above symptoms, especially diarrhea and stomach pain. After taking detailed medical history in these patients, a physical examination can also be performed by the physician. During the physical examination, the appearance of the body is examined, pressure is applied to the areas where pain is felt, whether there is a change in pain, it is checked for any swelling and the sounds from the body are listened with the help of a stethoscope. Endoscopy procedure is generally used in patients presenting with such complaints due to the symptoms indicating the digestive tract. In addition, some blood tests, stomach acid measurements and medical imaging tests can be used. As a result of endoscopy applications and medical imaging tests that allow the imaging of the upper gastrointestinal tract, the presence of gastrinomas tumors in the pancreas or small intestine can be easily detected, thus diagnosing the disease. A biopsy is taken from the tumors seen at this time and sent to pathology laboratories for examination. Whether the tumor is a gastrinoma tumor, benign (benign) or malignant, it can be clearly learned from this examination. At the end of all these examinations, the treatment process is planned and started as soon as possible in patients receiving Zollinger Ellison syndrome. In the event that the tumors are malignant, more detailed investigations should be carried out in case of spread to surrounding tissues and organs.
How is Zollinger ellison syndrome treated?
In patients diagnosed with Zollinger Ellison Syndrome, treatment should be initiated as soon as possible to prevent permanent damage to the organs of the gastrointestinal tract. In these patients, medications, surgical operations, chemotherapy and medical nutrition therapy are generally included in the treatment plan. First of all, in order to heal ulcers formed in the digestive system and to prevent new damages, drug therapy is recommended to help reduce the acid secretion of the stomach. These drugs are in a group of drugs called proton pump inhibitors and contain active ingredients such as esomeprazole, lansoprazole, pantoprazole, omeprazole, dexlansoprazole. As long-term use of these drugs may affect calcium absorption, supportive supplements may be recommended by the physician to prevent bone and spine diseases. Then, gastrinomas are removed with surgical operations, which is the only treatment option in Zollinger Ellison Syndrome. These tumors are usually malignant and because they are very small, it is quite difficult to detect and remove gastrinomas before they spread to different parts of the body. Gastrinomas most commonly spread to the liver and bones. If such a spreading condition is detected, additional chemotherapy applications should be made to the surgical operation. Also, chemotherapy can be applied for gastrinomas that are not suitable for surgical removal. As a result of the studies, it has been observed that the diet and style does not have an effect such as reducing the risk of getting Zollinger Ellison Syndrome or preventing the disease. However, the symptoms such as diarrhea, stomach pain and reflux caused by the disease can be significantly reduced by recommending a nutrition program such as diet applied in diseases such as gastritis and stomach ulcers. As a result of all these applications, the success of treatment is quite high, especially in patients diagnosed at an early stage.
If you have been diagnosed with Zollinger Ellison Syndrome or if you are experiencing symptoms related to this syndrome, you should contact a health institution immediately and undergo the necessary examinations with the guidance of your doctor. In this way, your illness can be treated without progressing, so you can live a healthy and long life.

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