Document Detail


Treatment strategies for Zollinger-Ellison syndrome.
MedLine Citation:
PMID:  19351273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Zollinger-Ellison syndrome (ZES) is a rare disorder caused by tumor secretion of the hormone gastrin, which results in gastric acid hypersecretion and secondarily complicated peptic ulcer and diarrhea. Until the development of H(2)-receptor antagonists and later proton pump inhibitors (PPIs), the disease was virulent, often associated with ulcer-related mortality, and the mainstay of treatment was total gastrectomy. OBJECTIVE: To evaluate current approaches to diagnosis and therapy, focusing on the role of PPIs. METHODS: An extensive literature search through PubMed using the search term 'Zollinger-Ellison syndrome' from 1964 to the present was performed. Primary articles were identified, and pertinent articles obtained from the reference lists were also examined. RESULTS/CONCLUSIONS: The clinical manifestations of ZES are well described, but overlaps with other more common disorders delay diagnosis. The use of abdominal imaging with somatostatin receptor scintigraphy and endoscopic ultrasound has improved tumor staging. PPI therapy is remarkably effective in controlling gastric acid hypersecretion, thereby reducing morbidity and potential mortality of this syndrome. The dose of drug necessary to control symptoms is highly variable but, even when used in high doses for prolonged periods of time, the disease remained controlled with very few drug-related side effects.
Authors:
C Mel Wilcox; Basil I Hirschowitz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  10     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1145-57     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology & Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. melw@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Histamine H2 Antagonists / therapeutic use*
Humans
Prognosis
Proton Pump Inhibitors / therapeutic use*
Zollinger-Ellison Syndrome / diagnosis,  drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Proton Pump Inhibitors

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