Zollinger–Ellison syndrome

Zollinger–Ellison syndrome 
First described in 1955 by Robert Zollinger and Edwin Ellison, surgeons at The Ohio State University.
Main features of this syndrome:

  • Gastric acid hypersecretion
  • Severe peptic ulceration
  • Non-beta cell islet tumor of pancreas
In this syndrome increased levels of the hormone Gastrin are produced, causing the stomach to produce excess hydrochloric acid resulting to severe peptic ulceration. The ulcers are formed in the stomach and in the duodenum. The hormone Gastrin is produced by the Non-beta cell tumor in pancreas. At times this tumorcalled Gastrinoma may be located in the duodenum.Gastrin acts on the parietal cells of the stomach and causes the hyperplasia of the parietal cells resulting to increase in the number of the acid secreting cells. It also acts by causing the increase in the output of the acid by the parietal cells. All this results to increase in the production of acid in the stomach and causes the multiple ulcers in the stomach and the duodenum.Gastrinomas may be single of multiple tumors. They may be malignant tumors and spread to Liver, lymphnode in the abdomen and in the small intestine.Nearly 25 percent of patients with gastrinomas have multiple tumors. Such patients have tumors in their pituitary gland and parathyroid glands in addition to tumors of the pancreas.
Symptoms of this condition consist of: Pain in epigastrium, upper abdomen. Diarrhea, Melina (Blood in stool). Vomiting, Weight Loss.This condition is suspected when the symptoms do not resolve with routine treatment.Tests which help in diagnosing this disease are

  • Upper Gastro intestinal Endoscopy, Measurement of Gastric acid secretion. Normal basal gastric acid secretion is less than 10 mEq/hour, while in Zollinger–Ellison syndrome it is usually more than 15 mEq/hour.
  • Level of hormone Gastrin, especially in fasting state.
  • Secretin stimulation test. This measures the level of gastrin after stimulation.

Secretin is a hormone that controls the secretions into the duodenum, and also water homeostasis  in the body. It is produced in the S cells of the duodenum in the crypts of Lieberkühn. Its effect is to regulate the pH of the duodenal contents via the control of gastric acid secretion.

  • Ultrasound, CT Scans and MRI help in diagnosis.
Treatment consists of Proton Pump inhibitors such as omeprazole, rabiprazole, and H2 receptor antagonists such as famotidine and ranitidine.Tumors have to be removed surgically and chemotherapy may be needed.
 Diseases & Conditions
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About Manbir & Gurpreet

Gurpreet Kaur’s journey in this world .... Gurpreet Kaur was a Musician. She was a singer and a composer of music. Her interest was composing and singing Gurbani Shabads in Indian Classical style. She sang Shabads in All the Raags mentioned in Sri Guru Granth Sahib Ji. She also taught Gurmat Sangeet at Gurmat Gian Missionary College, Jawadi, Ludhiana. Elder child to Pushpinder Kaur and Dr. Brig. Harminder Singh, was born in Amritsar on 13th Jan 1962. She attended various convent schools as a child because her father would get frequent Army postings as a dental surgeon. She graduated with Music Honors from Govt. College for Women, Chandigarh. Music was her hobby and she composed and sang Raag based Gurbani Shabads. Doing Kirtan was part of growing up nurtured by her parents. She learned music from her father Dr. Brigadier Harminder Singh who was a dental surgeon in Indian Army and a very good singer himself. Gurpreet’s Bhua (father’s sister), Ajit Kaur retied as a Head of Department of Music from Govt. College for Women Ludhiana, and was a renounced Punjabi singer of her time. Gurpreet Kaur also learned nuances of Indian Classical Music from Pandita Sharma. She was a mother of three children, and a grandmother. Her daughter Keerat Kaur is a Computer Engineer. Her two sons Gurkeerat Singh and Jaskeerat Singh are doctors in USA. Her daughter Keerat Kaur too was part of her group ~ Gurmat Gian Group. Gurpreet Kaur left this world at the age of 54yrs on 12th Sept 2016 in Baltimore USA. She had recorded around 25 cds of Gurbani Keertan. 'Raag Ratan' Album (6 CDs) is a Compilation of Shabads in All the 31 Sudh Raags of Sri Guru Granth Sahib Ji. 'Gauri Sagar' Album (3 CDs) is a Compilation of All forms of Raag Gauri in Sri Guru Granth Sahib Ji. 'Nanak Ki Malhaar' ~ ((3 CDs) is an album of Raag Malhar Shabads in various forms of Malhar. 'Gur Parsaad Basant Bana' ~ (3 CDs) is an album of Shabads in Raag Basant sung in various forms of Raag Basant. Har Ki Vadeyai Sarni Aayea Sewa Priya Kee Preet Piyaree Mohan Ghar Aavho Karo Jodariya Mo Kao Taar Le Raama Taar Le Tere Kavan Kavan Gun Keh Keh Gawan Mera Baid Guru Govinda Saajanrraa Mera Saajanrraa

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