The role of proton pump inhibitors in the treatment of Zollinger-Ellison syndrome.
Zollinger-Ellison syndrome is characterised by refractory peptic ulcer disease, diarrhoea and gastric acid hypersecretion associated with a gastrin-secreting tumour. The incidence is unknown, but, in the US, the frequency is 0.1-3.0 million people. Zollinger-Ellison syndrome is associated with multiple endocrine neoplasia type 1 in 25-35% of the cases. The diagnosis of Zollinger-Ellison syndrome is suggested when plasma gastrin is > 1000 pg/ml and the basal acid output is > 15 mEq/h or when associated with a pH < 2. The treatment is focused on controlling gastric acid hypersecretion and localisation of the tumour and its metastases. Proton pump inhibitors are the most effective antisecretory drugs and can be administered at high dosages. This review focuses on the role of the proton pump inhibitors in the management of gastric acid hypersecretion in Zollinger-Ellison syndrome.
Nieto
Jose M
JM
Division of Gastroenterology and Hepatology, Greater Los Angeles Veterans Medical Center, USA.
Pisegna
Joseph R
JR
D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000378:metabolism; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy* / Q000378:metabolism*
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D017494:Proton Pumps