Medical management of patients with Zollinger-Ellison syndrome who have had previous gastric surgery: a prospective study.
We examined prospectively the criteria for medical management in 16 patients with Zollinger-Ellison syndrome who had had previous gastric surgery. Each patient received sufficient antisecretory medication to lower gastric acid output to less than 10 mEq/h during the last hour before the next dose of drug. The 7 patients with a vagotomy but no gastric resection were symptom-free and had no mucosal disease. Of 9 patients with a partial gastrectomy, 7 had mucosal disease, with or without symptoms, and 6 of the 7 patients had acid outputs of 5-10 mEq/h. In these patients, antisecretory medication was increased to reduce output to less than 5 mEq/h and symptoms and mucosal abnormalities resolved in each patient. Patients with Zollinger-Ellison syndrome and a vagotomy can be treated safely by reducing acid secretion to less than 10 mEq/h, but in patients with a partial gastrectomy, acid secretion must be reduced to less than 5 mEq/h, and adequacy of therapy must be checked further by endoscopy.
Maton
P N
PN
Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
Frucht
H
H
Vinayek
R
R
Wank
S A
SA
Gardner
J D
JD
Jensen
R T
RT
D000293:Adolescent; D000328:Adult; D000368:Aged; D015738:Famotidine; D005260:Female; D005743:Gastrectomy; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011899:Ranitidine / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D014628:Vagotomy; D014629:Vagotomy, Proximal Gastric; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery
D013844:Thiazoles; D015738:Famotidine; D011899:Ranitidine