Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 7, Issue 2, Pages 169-175Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656566.7.2.169
Keywords
esomeprazole; gastric acid hypersecretion; gastrinoma; lansoprazole; multiple endocrine neoplasia type 1; omeprazole; pancreatic turnout; pantoprazole; peptic ulcer disease; proton pump inhibitors; rabreprazole; Zollinger-Ellison syndrome
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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.
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