Gastrinoma (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Gastrinoma is also called Zollinger-Ellison syndrome (ZES). It is a rare disease characterized by one or more tumors in the pancreas, duodenum, or both. The tumors can cause the stomach to produce too much gastric acid, leading to peptic ulcers in the duodenum. Sometimes the tumors are cancerous and may spread to distant organs. Usual symptoms include burning abdominal pain, nausea and vomiting, weight loss and diarrhea. Treatmens include proton pump inhibitors and surgery.

What are the symptoms of gastrinoma?

 * Usual syptoms include:


 * Burning in abdomen
 * Nausea and vomiting
 * Weight loss
 * Diarrhea


 * Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at risk for gastrinoma?
There is no specific known risk factor that is responsible for gastrinomas.

Diagnosis

 * Gastric acid level and the amount of gastrin circulating in the blood
 * Upper gastrointestinal (GI) endoscopy: During this procedure, the doctor uses a thin, flexible, lighted tube with a small camera on the tip to see inside the upper GI tract.
 * Somatostatin receptor scintigraphy (SRS): In this test, tumor cells can light up after the radiotracer is injected into the bloodstream. The signal can be scaned by the gamma camera.
 * A computerized tomography (CT) scan: CT scans are often used to diagnose gastrinoma. It can confirm the location of the cancer, as well as distant organs where the cancer might have spread.

When to seek urgent medical care?
Call your health care provider if symptoms of gastrinoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:


 * Severe burning in abdomen
 * Severe nausea, vomiting or diarrhea

Treatment options
The treatments include medications to relieve ulcer symptoms, surgery to remove tumors and chemotherapy. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities.


 * Proton pump inhibitors (PPI): This kind of drugs can effectively reduce gastric acid secretion in the stomach. Usual drugs include esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix) and omeprazole (Prilosec).
 * Surgery: Surgical removal of gastrinomas is the only cure for gastrinoma.
 * Chemotherapy: For those the tumor can not be surgically removed, chemotherapy is available. The drugs include streptozotocin (Zanosar), 5-fluorouracil (Adrucil) and doxorubicin (Doxil).

Diseases with similar symptoms

 * Peptic ulcer
 * Gastroesophageal reflux disease
 * Hypergastrinemia

Where to find medical care for gastrinoma?
Directions to Hospitals Treating gastrinoma

Prevention of gastrinoma
As a rare disease, the cause of gastrinoma is not clear. And the preventive measure is not known.

What to expect (Outook/Prognosis)?
The outcome for patients with gastrinoma largely depends on the nature and extent of the disease.