Zollinger-Ellison syndrome (ZES) is a disease in which tumors cause the stomach to produce too much acid, resulting in peptic ulcers. Symptoms include abdominal pain and diarrhoea.

Causes :-

The syndrome is caused by a gastrinoma, a neuroendocrine tumour that secretes a hormone called gastrine. The tumor causes excessive production of gastric acid, which leads to the growth of gastric mucosa and proliferation of parietal and ECL cells.

Note :-

Zollinger-Ellison syndrome (ZES) may occur on its own or as part of anautosomal dominant syndrome called multiple endocrine neoplasia type 1 (MEN 1). The primary tumor is usually located in the pancreas,duodenum or abdominal lymph nodes, but ectopic locations (e.g. heart,ovary,gallbladder,liver and kidney) may also get involved.

ACIDOCID tablet:- 2 to 3 tablets to be chewed and swallowed with clean water

ACIDOCID syrup :- 3 teaspoonful mixed with clean water 3 to 4 times a day for the period upto healing occurs.

GULVALEX capsule :- 1 capsule 3 to 4 times a day to be swallowed with celan water for containing the gastric parietal swellings for the period upto healing occurs.

Signs and symptoms of Zollinger-Ellison syndrome (ZES) Patients with Zollinger-Ellison syndrome may experience abdominal pain and diarrohea. The diagnosis is also suspected in patients who have severe ulceration of the stomach and small intestine, especially if they fail to respond to treatment. Main signs and symptoms are: Chronic diarrhea, including steatorrhoea (fatty stools)

Pain in the esophagus, especially between and after meals at night
Nausea
Wheezing
Vomiting blood
Malnourishment
Loss of appetite

Gastrinomas may occur as single tumors or as multiple small tumors. About one-half to two-thirds of single gastrinomas are malignant tumors that most commonly spread to the liver and to lymph nodes near the pancreas and small intestine. Nearly 25 percent of patients with gastrinomas have multiple tumors as part of a condition called multiple endocrine neoplasia type 1 (MEN 1). MEN I patients have tumors in their pitutary gland and parathyroid glands, in addition to tumours of the pancreas.

What is the path-physiology of Zollinger-Ellison syndrome (ZES)?

Gastrin works on the parietal cells of the gastric glands, causing them to secrete more hydrogen ions into the stomach lumen. In addition, gastrin acts as a trophic factor for parietal cells, causing parietal cell hyperplasia. Thus, there is an increase in the number of acid-secreting cells, and each of these cells produces acid at a higher rate. The increase in acidity contributes to the development of peptic ulcers in the stomach,duodenum (first portion of the small intestinel) and occasionally the jejunum (second portion of the small intestine)– the last of which is an ‘atypical’ ulcer.

What is the treatment of Zollinger-Ellison syndrome (ZES)?

ACIDOCID tablet: for inhibiting the increased acid secretion.Dose:2 to 3 tablets to be chewed and swallowed with clean water mixed 3 teaspoonful of below described ACIDOCID syrup for the period upto healing occurs.

GULVALEX capsule: 1 capsule 3 to 4 times a day to be swallowed with celan water for containing the gastric parietal swellings for the period upto healing occurs.

ACIDOCID syrup: 2 to 3 teaspoonful mixed with clean water 3 to 4 times a day besides with intake of ACIDOCID tablets for the period upto healing occurs.