How to Treat Gastrinoma

Gastrinomas are tumors that usually occur in the pancreas and the first part of the small intestine (duodenum). These tumors are associated with the Zollinger-Ellison syndrome, which is a condition caused by an abnormal increase in hormone gastrin. When gastrinoma is present, it secretes gastrin in the blood, higher than the normal level. This will then trigger an increase in the production of gastric acid that leads to one of the most prominent symptoms of gastrinoma--severe ulceration of the stomach and small intestine. Other symptoms include abdominal pain, diarrhea, and occasional vomiting of blood. Gastrinoma equally affects both males and females and is common in ages 30 to 50 years old. The occurrence of this case is mostly sporadic, with 30% of it being part of a genetic condition known as multiple endocrine neoplasia type I (MEN I).

Difficulty: Moderate

Instructions

Things You'll Need:

• Prepare either of the following acid-reducing medications:
• Proton pump inhibitors such as Lansoprazole or Omeprazole
• or
• Histamine (H-2) blockers such as Cimetidine or Ranitidine

How to Treat Gastrinoma

1. Take some acid-reducing medications known as proton pump inhibitors (Lansoprazole or Omeprazole). These medications do not only block the acid-secreting cells, but also promote healing of ulcers, and provide relief in abdominal pain and diarrhea.

2. Taking histamine (H-2) blockers (Cimetidine or Ranitidine) are also helpful. These types of medications do not work as much as proton pump inhibitors, but are helpful in reducing the amount of hydrochloric acid produced in the digestive tract.

3. Application of agents such as, chemotherapy and interferon may be helpful, especially on metastatic cases.

4. Surgical removal of the tumor (such as Laparotomy) is advisable for individuals with a sporadic type of gastrinoma or those without any signs of metastases. This is done to prevent the risk of spreading the tumor on the liver and other organs.

5. Surgical treatment is also recommended for individuals with gastrinoma secondary to multiple endocrine neoplasia type I (MEN I). Although the effect of tumor resection regarding this case is unclear, it somehow helps in decreasing the risk of metastases, especially on tumors larger than 2.5 cm.

6. Radiotherapy with the use of 90Y- DOTA lanreotide can be prescribed. This method only decreases the size of the tumor, without reducing the production of gastric acid.

Tips & Warnings

• Contact the doctor right away at the very onset of symptoms; especially when the case involves vomiting of blood.
• Do not take any medications without the doctors’ advice.
• Consultations from a gastroenterologist, surgeon, and oncologist must be provided in order to know the updates of the condition.

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