How to Diagnose Zollinger-Ellison Syndrome
Zollinger-Ellison syndrome is characterized by peptic ulcers caused by an excess secretion of gastric acid produced by gastric tumors. Gastrinomas are usually found in the duodenum but also may arise in the pancreas as non-beta islet cell tumors. Patients with Multiple Neuroendocrine Tumors are considered to fit the profile for Zollinger-Ellison syndrome in up to 61 percent of cases. The following steps will show how to diagnose Zollinger-Ellison syndrome.
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Instructions
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Observe severe abdominal pain due to peptic ulcers to be the most common presenting symptom of Zollinger-Ellison syndrome. These ulcers are found in the upper gastrointestinal (GI) tract in 90 to 95 percent of these cases.
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Expect the second most common symptom of Zollinger-Ellison syndrome to be diarrhea, which occurs in up to 65 percent of all patients. This is because of mucosal damage caused by excess gastric acid, which also may cause steatorrhea.
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Examine the patient for abdominal tenderness or other signs of a perforated duodenum. Bleeding ulcers can cause a pale complexion and a rapid heart rate because of anemia.
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Conduct specific laboratory studies when Zollinger-Ellison syndrome is suspected. A gastrin level greater than 100 pg/mL is highly suggestive and a level greater than 1,000 pg/mL with a gastric level pH less than 2 confirms the diagnosis.
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Perform a secretin stimulation test if the gastrin level is between 100 and 200 pg/mL with a pH level is less than 2. Administer two IU/kg of secretin intravenously and draw blood at 2.5, 5, 10, 15 and 30 minutes. Zollinger-Ellison syndrome can be diagnosed if the gastrin level rises above 200 pg/mL.
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