Zollenger‑Ellison Syndrome: What You Need to Know

If you’ve heard the term Zollinger‑Ellison syndrome (ZES) and feel confused, you’re not alone. It’s a rare condition that makes your stomach produce too much acid, which can cause painful ulcers and other digestive problems. The good news is that doctors have clear ways to diagnose it and there are several treatment options that work well.

What Is Zollinger‑Ellison Syndrome?

ZES starts with tiny tumors called gastrinomas. These tumors grow in the pancreas or the upper part of the small intestine and release a hormone named gastrin. Gastrin tells your stomach to crank up acid production, sometimes by tenfold. The excess acid then eats away at the lining of the stomach and duodenum, creating ulcers that don’t heal easily.

People with ZES often notice burning pain in the upper abdomen, especially after meals, or they get frequent heartburn that doesn’t respond to over‑the‑counter antacids. Some also experience diarrhea, weight loss, or nausea. Because these symptoms look like common acid‑related issues, doctors may need special tests—blood gastrin levels, secretin stimulation test, and imaging scans—to confirm the diagnosis.

Managing Symptoms and Treatment

The first step in treatment is to tame the acid. Proton pump inhibitors (PPIs) such as omeprazole or esomeprazole are very effective; they can reduce acid output by up to 90 %. Most patients stay on a high dose for life, but doctors may lower it over time if symptoms improve.

If medication isn’t enough, surgery becomes an option. Removing the gastrinoma can cure the disease in some cases, especially when the tumor is small and hasn’t spread. For larger or metastatic tumors, chemotherapy, targeted therapy (like everolimus), or peptide‑receptor radionuclide therapy may be recommended.

Living with ZES also means paying attention to diet. Avoiding very spicy foods, caffeine, alcohol, and large meals can reduce irritation. Eating smaller, more frequent meals helps keep acid spikes under control.

Regular follow‑up is key. Doctors will monitor gastrin levels and do periodic imaging to catch any new tumor growth early. With the right combination of medication, possible surgery, and lifestyle tweaks, most people with Zollinger‑Ellison syndrome can lead normal lives.