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Zollinger-Ellison Syndrome and Other Acid-Hypersecretory States

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Diseases of the Gastroesophageal Mucosa

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

The normal stomach secretes acid continuously, even in the absence of any stimulation. This basal acid secretion can be augmented by natural stimuli, such as sight, smell, or ingestion of food, or by pharmacological methods. Basal acid secretion is up to 5.6 mEq/h in women and up to 10.5 mEq/h in men. After stimulation with gastrin or histamine analogs, maximal acid output is 5–32 mEq/h in women and 7–48 mEq/h in men (1).

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References

  1. Feldman M. (1989) Gastric secretion in health and disease. In: Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, ed. 4. Sleisenger MM, Fordtran JS, eds. Philadelphia: WB Saunders pp. 713–734.

    Google Scholar 

  2. Hirschowitz BI, Mohnen J, Shaw S. (1996) Long term treatment with lansoprazole in patients with duodenal ulcer and basal acid output of more than 15mmol/h. Aliment Pharmacol Ther 10: 497–506.

    Article  PubMed  CAS  Google Scholar 

  3. Wolfe MM, Jensen RT. (1987) Zollinger-Ellison syndrome. N Engl J Med 317: 1200–1209.

    Article  PubMed  CAS  Google Scholar 

  4. Maton PN, Dayal Y. (1991) Clinical implications of hypergastrinemia. In Peptic Ulcer Disease and Other Acid-related Disorders Zakim D, Dannenburg AJ, eds., New York: Academic Research, pp. 213–246.

    Google Scholar 

  5. Frucht H, Howard JM, Slaff JI, et al. (1989) Secretin and calcium provocative tests in Zollinger-Ellison syndrome: a prospective study. Ann Intern Med 111: 713–722.

    PubMed  CAS  Google Scholar 

  6. Collen MJ, Jensen RT. (1994) Idiopathic gastric acid secretion: comparison with Zollinger-Ellison syndrome. Dig Dis Sci 39: 1434–1440.

    Article  PubMed  CAS  Google Scholar 

  7. El-Omar EM, Penman ID, Ardill JES, et al. (1995) Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer. Gastroenterology 109: 681–691.

    CAS  Google Scholar 

  8. Graham DY, Opekun A, Lew GM, et al. (1990) Ablation of exaggerated meal-stimulated gastrin release in duodenal ulcer patients after clearance of Helicobacter (Campylobacter) pylori infection. Am J Gastroenterol 85: 394–398.

    PubMed  CAS  Google Scholar 

  9. Metz DC, Weber HC, Orbuch M, et al. (1995) Helicobacter pylori infection: a reversible cause of hypergastrinemia and hyperchlorhydria which may mimic Zollinger-Ellison syndrome. Dig Dis Sci 40: 153–159.

    CAS  Google Scholar 

  10. Hagen D, Malz GS, Anderson CM. (1989) Marked hypergastrinemia in gastric outlet obstruction. J Clin Gastroenterol 11: 442–444.

    Article  Google Scholar 

  11. Korman MG, Scott DF, Hansby J. (1972) Hypergastrinemia due to excluded gastric antrum: a proposed method for differentiation from Zollinger-Ellison syndrome. Aust NZ J Med 3: 266–271.

    Article  Google Scholar 

  12. Lewis KJ, Yang K, Ulrich T, et al. (1984) Primary gastrin hyperplasia: report of five cases and a review of the literature. Am J Surg Pathol 8: 821–832.

    Article  Google Scholar 

  13. Annibale B, Rindi G, D’Ambra G, et al. (1996) Antral gastrin cell hyperfunction and Helicobacter pylori infection. Aliment Pharmacol Ther 10: 607–616.

    Article  PubMed  CAS  Google Scholar 

  14. Cherner JA, Jensen RT, Dubois A, et al. (1985) Hyperhistaminemia and hyperchlorhydria in basophilic granulocytic leukemia. Gastroenterology 95: 657–667.

    Google Scholar 

  15. Olinger EJ, McCarthy DM, Young RC, et al. (1976) Hyperhistaminemia and hyperchlorhydria in basophilic granulocytic leukemia. Gastroenterology 71: 667–669.

    PubMed  CAS  Google Scholar 

  16. Roberts LJ II, Marney SR, Oates JA. (1979) Blockade of the flush associated with metastatic gastric carcinoid by combined histamine H1 and H2 receptor antagonists: evidence for an important role of H2 receptors in human vasculature. N Eng J Med 300: 237–238.

    Article  Google Scholar 

  17. Song Y, Chey WY, Chang T-M, et al. (1997) Mechanism of gastric acid hyper-secretion in patients with islet cell tumor without hypergastrinemia: studies in rats. Gastroenterology 113: 1129–1135.

    Article  PubMed  CAS  Google Scholar 

  18. Saeed ZA, Norton JA, Frank WO, et al. (1989) Parenteral antisecretory drug therapy in patients with Zollinger-Ellison syndrome. Gastroenterology 96: 1393–1402.

    PubMed  CAS  Google Scholar 

  19. Maton PN. (1991) Role of acid suppressants in patients with Zollinger-Ellison syndrome. Aliment Pharmacol Ther 5 (Suppl 1): 25–36.

    PubMed  Google Scholar 

  20. Howard JM, Chremos AN, Collen MJ, et al. (1985) Famotidine, a new potent long acting histamine H2 receptor antagonist comparison with cimetidine and ranitidine in patients with Zollinger-Ellison syndrome. Gastroenterology 88: 1026–1033.

    PubMed  CAS  Google Scholar 

  21. Lew EA, Pisegna JR, Starr J, et al. (2000) Intravenouspantoprazole rapidly controls gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. Gastroenterology 118: 696–704.

    Article  PubMed  CAS  Google Scholar 

  22. Frucht H, Maton PN, Jensen RT. (1991) Use of omeprazole in patients with Zollinger-Ellison syndrome. Dig Dis Sci 36: 394–404.

    Article  PubMed  CAS  Google Scholar 

  23. Metz DC, Pisegna JR, Ringham GL, et al. (1993) Prospective study of efficacy and safety of lansoprazole in Zollinger-Ellison syndrome. Dig Dis Sci 38: 245–256.

    Article  PubMed  CAS  Google Scholar 

  24. Metz DC, Pisegna JR, Fishbeyn VA, et al. (1992) Currently used doses of omeprazole in Zollinger-Ellison syndrome are too high. Gastroenterology 103: 1496–1508.

    Google Scholar 

  25. Hirschowitz BI, Mohnen J, Shaw S: (1996) Long term treatment with lansoprazole for patients with Zollinger-Ellison syndrome. Aliment Pharmacol Ther 10: 507–522.

    Article  PubMed  CAS  Google Scholar 

  26. Mignon M, Merrouche M, Gardner JD, et al. (1999) Rabeprazole therapy is effective in Zollinger-Ellison syndrome and idiopathic gastric acid secretion. Am J Gastroenterol 94: 2613 (Abstract).

    Google Scholar 

  27. Metz DC, Forsmark CE, Soffee E, et al. (1999) Zollinger-Ellison syndrome (ZES) patients can replace oral proton pump inhibitors (PPIs) with intravenous (IV) pantoprazole (PANTO) without using control of acid output (AO). Gastroenterology 116: A252 (Abstract).

    Google Scholar 

  28. Solcia E, Capella C, Fiocca R, et al. (1990) Gastric argyrophil carcinoidosis in patients with Zollinger-Ellison syndrome due to type 1 multiple endocrine neoplasia: a newly recognized association. Am J Surg Pathol 14: 503–513.

    Article  PubMed  CAS  Google Scholar 

  29. Maton PN, Lack EE, Collen MJ, et al. (1990) The effect of Zollinger-Ellison syndrome and omeprazole therapy on gastric oxyntic endocrine cells. Gastroenterology 99: 943–950.

    PubMed  CAS  Google Scholar 

  30. Maton PN, Frucht H, Vinayek R, et al. (1988) Medical management of patients with Zollinger-Ellison syndrome who have had previous gastric surgery: a prospective study. Gastroenterology 94: 294–299.

    PubMed  CAS  Google Scholar 

  31. Richardson CT, Peters MN, Feldman M, et al. (1985) Treatment of ZollingerEllison syndrome with exploratory laparotomy, proximal gastric vagotomy and H2-receptor antagonists: a prospective study. Gastroenterology 89: 357–367.

    PubMed  CAS  Google Scholar 

  32. Norton JA, Cornelius MJ, Doppman JL, et al. (1987) Effect of parathyroidectomy in patients with hyperparathyroidism and Zollinger-Ellison syndrome and multiple endocrine neoplasia type I: a prospective study. Surgery 102: 958–966.

    PubMed  CAS  Google Scholar 

  33. Bale AE, Norton JA, Wong EL, et al. (1991) Allelic loss on chromosome 11 in hereditary and sporadic tumors related to familial multiple endocrine neoplasia type 1. Cancer Res 51: 1154–1157.

    PubMed  CAS  Google Scholar 

  34. Termanini B, Gibril F, Reynolds JC, et al. (1997) Value of somatostatin receptor scintigraphy: a prospective study in gastrinoma of its effect on clinical management. Gastroenterology 112: 335–347.

    Article  PubMed  CAS  Google Scholar 

  35. Von Schrenk T, Howard JM, Doppman JL, et al. (1988) Prospective study of chemotherapy in patients with metastatic gastrinoma. Gastroenterology 94: 1326–1334.

    Google Scholar 

  36. Maton PN. (1989) The use of the long-acting somatostatin analogue, octreotide in patients with islet cell tumors. Gastroenterol Clin North Am 18: 897–922.

    CAS  Google Scholar 

  37. Trautmann ME, Neuhause C, Bruns C, et al. (1990) Secondary failure of growth inhibition by SMS 201–995 is accompanied by increased hormone levels without loss of SMS receptors. Digestion 46 (Suppl 1): 115–116.

    Google Scholar 

  38. Pisegena JR, Slimak GG, Doppman JL, et al. (1993) An evaluation of human recombinant a interferon in patients with metastatic gastrinoma. Gastroenterology 105: 1179–1183.

    Google Scholar 

  39. Erickson B, Oberg K, Alm G, et al. (1986) Treatment of malignant endocrine pancreatic tumors with human leukocyte interferon. Lancet 2: 1307–1308.

    Article  Google Scholar 

  40. Carrasco CH, Chuang VP, Wallace S. (1983) Apudoma metastatic to the liver. Treatment by hepatic artery embolization. Radiology 149: 79–83.

    PubMed  CAS  Google Scholar 

  41. Thom A, Norton J, Axiotis C, et al. (1991) Location, incidence, and malignant potential of duodenal gastrinomas. Surgery 110: 1086–1093.

    PubMed  CAS  Google Scholar 

  42. Norton J, Doppman J, Jensen R. (1992) Curative resection in Zollinger-Ellison syndrome: results of a 10-year prospective study. Ann Surg 215: 8–18.

    Article  PubMed  CAS  Google Scholar 

  43. Donow C, Pipeleers-Marichal M, Schroder S, et al. (1991) Surgical pathology of gastrinoma: site, size, multicentricity, association with multiple endocrine neoplasia type 1, and malignancy. Cancer 68: 1329–1334.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Paul N. Maton MD
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Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA

    James W. Freston MD, PhD

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© 2001 Humana Press Inc., Totowa, NJ

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Maton, P.N. (2001). Zollinger-Ellison Syndrome and Other Acid-Hypersecretory States. In: Freston, J.W. (eds) Diseases of the Gastroesophageal Mucosa. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-103-9_6

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  • DOI: https://doi.org/10.1007/978-1-59259-103-9_6

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9642-0

  • Online ISBN: 978-1-59259-103-9

  • eBook Packages: Springer Book Archive

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