Definition
Zollinger-Ellison Syndrome is a serious morbid condition, with a fatal course for most of the cases: it is an ulcerative neoplasm affecting the upper digestive tract, often accompanied by diarrhea and abdominal pain of varying degrees.
Causes
Responsible for the Zollinger-Ellison Syndrome is a tumor of the endocrine system (often involving the pancreas or small intestine), in which an "exaggerated amount of gastrin is produced (100-1,000 times higher than the average). The" abnormal amount of gastrin, secreted from 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.
The information on Medicines 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 Medicines.
Medicines
The drugs used in the treatment of Zollinger-Ellison Syndrome are the same used for esophagitis, for gastroesophageal reflux diseases and for peptic ulcer, but they must be administered at a higher dosage, after consulting a doctor:
Proton pump inhibitors (carry out 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. Maintenance care is important: take 100mg of the drug once a day, or two 60mg tablets twice a day. Continue the therapy for up to one year, except for different indications dictated by the doctor.
- Esomeprazole (eg Lucen, Nexium): it is recommended to take one tablet orally 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 orally once a day. In some cases, the dosage is increased to 90 mg, twice a day. In some patients, the syndrome needs to be treated with drugs for 4 years.
Histamine H2 receptor antagonists (exert their activity by 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 daily (or 60 mg twice daily) may be administered orally; continue the therapy for a maximum of one year.
- Ranitidine (eg Zantac): oral administration of 150 mg of active twice a day is recommended. In any case, within 24 hours it is possible to take a maximum of 6 g of drug: 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 nevertheless represent a valid aid in decreasing stomach acidity (by increasing gastric pH, the drug acts as a buffer and antacid);
- Aluminum hydroxide + magnesium hydroxide (eg Maalox plus): it is preferable to combine together the two active ingredients, since 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 at bedtime
- Magnesium hydroxide (eg Magnesia), in addition to exerting its action as an antacid, produces a discreet laxative effect. Take one 800 mg tablet before meals.
Surgical intervention: tumor extrusion can be performed surgically in cases where the absence of metastases is effectively demonstrated (extension of the tumor to other areas, such as lymph nodes and liver): in such situations, definitive removal of gastrinomas undoubtedly represents the therapy of choice and the only cure for Zollinger-Ellison syndrome.
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