Do You have persistent Peptic ulcer disease GASTRINOMA
Do You have persistent Peptic ulcer disease?
A gastrinoma is a tumor usually in the pancreas or duodenum (the first segment of the small intestine) that produces excessive levels of the hormone gastrin, which stimulates the stomach to secrete acid and enzymes, causing peptic ulcers. Most people with gastrinomas have several tumors clustered in or near the pancreas. About half of the tumors are cancerous. Sometimes a gastrinoma occurs as part of multiple endocrine neoplasias, a hereditary disorder in which tumors arise from the cells of various endocrine glands, such as the insulin-producing cells of the pancreas.
Symptoms and Diagnosis
The excess gastrin secreted by the gastrinoma causes Zollinger-Ellison syndrome in which a person suffers the symptoms of aggressive peptic ulcers in the stomach, duodenum, and elsewhere in the intestine. However, as many as 25% of people with Zollinger-Ellison syndrome may not have an ulcer when the diagnosis is made. Rupture, bleeding, and obstruction of the intestine can occur and are life-threatening. For more than half of the people with a gastrinoma, symptoms are no worse than those experienced by people with ordinary peptic ulcer disease. In 25 to 40% of people, diarrhea is the first symptom.
A doctor suspects a gastrinoma when a person has frequent peptic ulcers or several peptic ulcers that do not respond to the usual ulcer treatments. Blood tests to detect abnormally high levels of gastrin are the most reliable diagnostic tests.
Once blood tests diagnose gastrinoma, doctors use several imaging techniques, such as computed tomography (CT) of the abdomen, scintigraphy (a type of radionuclide scanning), endoscopic ultrasonography, PET scans, and arteriography (an x-ray taken after a radiopaque dye is injected into an artery), to locate tumors. These tumors may be difficult to find, however, because usually, they are small.
If the tumor is completely surgically removed, people have a greater than 95% chance of surviving 5 to 10 years. If the tumor is not completely removed, people have a 43% chance of surviving 5 years and a 25% chance of surviving 10 years.
Dr. Rakesh Rai. MS, FRCS, MD, CCT, ASTS Fellow