[Application of proton pump inhibitor to special conditions; Zollinger-Ellison syndrome].
Before the mid-1970s, the most reliable therapy for Zollinger-Ellison syndrome (Z-E syndrome) was total gastrectomy since complete excision of gastrinoma is difficult in many cases due to multifocus and/or metastases. With the advent of H2-blockers gastric acid secretion can be controlled at safe levels (less than 10 mEq/h), and patients with Zollinger-Ellison syndrome can be managed medically. The problem of therapy with H2-blockers however, is that large doses are usually required and that a marked tachyphylaxis is frequently noted during long-term treatment. Treatment with new antisecretory drug, proton pump inhibitor, has been shown to be highly effective with relatively high doses and without tachyphylaxis, although long-term experience is still limited.
6th Department of Internal Medicine, School of Medicine, Tokai University.
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Tani
D000251:Adenosine Triphosphatases / Q000037:antagonists & inhibitors*; D000328:Adult; D003131:Combined Modality Therapy; D003864:Depression, Chemical; D005744:Gastric Acid / Q000378:metabolism; D017506:H(+)-K(+)-Exchanging ATPase; D006635:Histamine H2 Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015043:Zollinger-Ellison Syndrome / Q000503:physiopathology / Q000628:therapy*
D006635:Histamine H2 Antagonists; D000251:Adenosine Triphosphatases; D017506:H(+)-K(+)-Exchanging ATPase; D009853:Omeprazole