Definition
Zollinger-Ellison syndrome is a serious morbid condition, with a fatal course for most cases: it is an ulcerative neoplasm affecting the upper digestive tract, often accompanied by diarrhea and abdominal pains of varying degrees.
Causes
Responsible for Zollinger-Ellison syndrome is a tumor of the endocrine system (often involving pancreas or small intestine), in which an exaggerated amount of gastrin (100-1, 000 times higher than average) is produced. The abnormal amount of gastrin, secreted by gastrinomas, is responsible for the appearance of ulcerative lesions in the digestive tract.
Symptoms
The most recurrent symptoms related to Zollinger-Ellison syndrome are: diarrhea, dysphagia, abdominal pain, hypoglycemia, heartburn and vomiting with traces of blood.
Information on Drugs for the Treatment of Zollinger-Ellison Syndrome is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Zollinger-Ellison Syndrome Drugs.
drugs
The drugs used in the treatment of Zollinger-Ellison Syndrome are the same as those used for oesophagitis, gastroesophageal reflux disease and peptic ulcer, but they must be administered at a higher dosage, after medical consultation:
Proton pump inhibitors (perform their therapeutic activity by inhibiting the secretion of gastric acids and promoting the healing of gastroduodenal ulcers):
- Rabeprazole (eg. Pariet): start therapy with 60 mg of active ingredient, to be taken once a day after breakfast. Important maintenance treatment: take 100mg of the drug once a day, or two 60mg tablets twice a day. Continue the treatment for up to a year, except for different indications dictated by the doctor.
- Esomeprazole (eg Lucen, Nexium): it is recommended to take an oral tablet of 40 mg per day. Up to 240 mg of active ingredient per day can be taken, as determined by the doctor.
- Lansoprazole (eg. Lansox, Pergastid): generally, to treat Zollinger-Ellison syndrome it is recommended to administer 60 mg of active per os once a day. In some cases, the dosage is increased to 90 mg twice a day. In some patients, the syndrome should be treated with drugs for 4 years.
Histamine H2-receptor antagonists (exercise their activity reducing gastric secretion):
- Famotidine (eg Famotidine EG): parenteral administration of 20 mg of active every 6 hours is recommended. Alternatively, a dose of 100 mg once a day (or 60 mg twice a day) can be administered orally; continue the therapy for up to one year.
- Ranitidine (eg Zantac): oral administration of 150 mg of active twice a day is recommended. However, within 24 hours it is possible to take a maximum of 6 g of medication: the dosage must be established by the doctor on the basis of gastric acid secretion. Parenterally, 1 mg / kg is administered as an intravenous infusion (max. 2.5 mg / kg), at a rate not exceeding 220 mg / hour.
Antacids
Although antacids are not the drugs of choice used for the treatment of Zollinger-Ellison syndrome, they are nevertheless a valid aid in decreasing stomach acidity (increasing the gastric pH, the drug acts as a buffering and antacid);
- Aluminum hydroxide + magnesium hydroxide (eg Maalox plus): it is preferable to combine the two active ingredients together, given that they have opposite side effects (magnesium hydroxide is a laxative, aluminum hydroxide is responsible for constipation). Take 2-4 tablets per day (500-1500 mg) with plenty of water, 20-60 minutes before meals and before bedtime
- Magnesium hydroxide (eg Magnesia), besides exerting its action as an antacid, produces a fairly good laxative effect. Take one 800 mg tablet before meals.
Surgery : the extrusion of the tumor can be performed surgically in cases where the absence of metastases (extension of the tumor to other areas, such as lymph nodes and liver) is actually demonstrated: in similar situations, the definitive removal of gastrinomas is undoubtedly the therapy of choice as well as the only cure for Zollinger-Ellison syndrome.
