Zollinger-Ellison Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

by Kenneth Kee

Overview

This book describes Zollinger-Ellison Syndrome, Diagnosis and Treatment and Related Diseases
Zollinger-Ellison syndrome (ZES) is an endocrine disorder featured by gastrin-secreting tumors, which produce multiple, refractory and repeat peptic ulcers in the distal duodenum and proximal jejunum.
There are two main types:
1. Sporadic (isolated).
2. ZES linked disorders with parathyroid and pituitary tumors as part of the genetic disorder multiple endocrine neoplasia type 1 (MEN1).
The tumor (gastrinoma) is normally in:
1. The duodenum (60-65%) or
2. The pancreas (30%).
Rarely, gastrinomas happen in other abdominal sites (e.g., the stomach, liver, bile duct, ovary) and also extra-abdominal sites (e.g., the heart, lung - small cell lung cancer).
Causes
Zollinger-Ellison syndrome is produced by tumors.
These tumors are most often present in the head of the pancreas and the upper small intestine.
The tumors are termed gastrinomas
Besides secreting high levels of gastrin, these tumors may secrete other hormones such as:
1. Adrenocorticotrophic hormone (ACTH),
2. Vasoactive intestinal polypeptide (VIP).
They can also form a range of peptides, such as:
1. Insulin,
2. Pancreatic polypeptide,
3. Glucagons,
4. Chromogranin A,
5. Neuron-specific enolase, and
6. The alpha and beta subunits of human chorionic gonadotrophin (hCG).
High levels of gastrin produce formation of too much stomach acid.
Symptoms
1. Abdominal pain
2. Diarrhea
3. Vomiting blood
Signs are ulcers in the stomach and small intestine.
Diagnosis:
It is very frequent for ZES to be treated early as a simple peptic ulcer.
The combination with pain with diarrhea may indicate the diagnosis.
Hyper-gastrinemia is described as fasting serum gastrin concentration >100 pg/ml and is seen often in medical disorders other than ZES such as:
1. Proton pump inhibitor (PPI) or H2-receptor antagonist therapy,
2. Post-vagotomy,
3. Renal failure and
4. Chronic atrophic gastritis.
If ZES is confirmed, it is important to determine MEN1, and calcium, parathyroid hormone and prolactin levels should be evaluated.
If the diagnosis is indicated, then more specific tests are needed - there is one algorithm from Liverpool:
Assessment of fasting gastrin level - levels >1000 pg/ml with acidic gastric juice (pH200 pg/ml 15 minutes after the dose is administered.
Treatment
Medicines called proton pump inhibitors (omeprazole, lansoprazole, and others) are given to decrease acid production by the stomach.
This reduction of acid helps the ulcers in the stomach and small intestine to heal.
In patients with liver metastases, surgery should be done followed by chemotherapy.

TABLE OF CONTENT
Introduction
Chapter 1 Zollinger-Ellison Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Barrett Esophagus
Chapter 8 Gastro-esophageal Reflux Disease
Epilogue

Product Details

BN ID:	2940155329862
Publisher:	Kenneth Kee
Publication date:	07/10/2018
Sold by:	Smashwords
Format:	eBook
File size:	142 KB

About the Author

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 65. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com. This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 550 amazon kindle books and some into Smashwords.com eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical conditions. The first chapter of all my ebooks is always taken from my blog A Simple Guide to Medical Conditions which was started in 2007 as a simple educational help to my patients on my first blog http://kennethkee.blogspot.com. The medical condition was described simply and direct to the point. Because the simple guide as taken from the blog was described as too simple, I have increased the other chapters to include more detailed description of the illness, symptoms, diagnosis and treatment. As a result there are the complaints by some readers of constant repetitions of the same contents but in detail and fairly up to date. He has published 550 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Bouna Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. All the PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"