Zollinger-Ellison syndrome: what a tiny tumor can do to your stomach
One small tumor — usually in the pancreas or nearby gut — can push your stomach to make too much acid. That’s Zollinger-Ellison syndrome (ZES). The extra acid causes stubborn ulcers, bad reflux, and often diarrhea. It’s rare, but when it happens, symptoms can be confusing and long-lasting unless someone looks for the right cause.
Symptoms to watch for
Look out for ulcers that won’t heal or keep coming back in unusual places (like the lower small intestine). You might have intense heartburn or acid reflux that doesn’t respond to regular treatment. Chronic diarrhea and weight loss are common because acid can upset digestion. Some people feel weak, have iron-deficiency anemia from bleeding ulcers, or wake at night with stomach pain. If you have repeated peptic ulcers or very high stomach acid, ask your doctor about ZES.
How doctors check and treat Zollinger-Ellison syndrome
Diagnosis starts with blood tests that measure gastrin, the hormone that tells your stomach to make acid. If gastrin is unusually high, doctors use imaging — CT or MRI at first, and specialized scans (like somatostatin-receptor PET) to find small tumors. Some patients are checked for MEN1, a genetic condition that raises the chance of multiple tumors.
Treatment has two aims: control acid and remove the tumor when possible. High-dose proton pump inhibitors (PPIs) usually control the acid very well and quickly relieve pain and diarrhea. If the tumor is localized and operable, surgeons may remove it. For tumors that have spread or can’t be fully removed, options include targeted drugs, somatostatin analogs, and careful follow-up. Your care team will often include a gastroenterologist, an endocrinologist, and a surgeon.
Practical tips: avoid NSAIDs (they increase ulcer risk) and don’t smoke — both make ulcers worse. Keep a record of symptoms, medicines, and tests so your specialists can see patterns. If you’re on acid medicines but still have severe pain, vomiting, fainting, or black stools, head to the ER — those can be signs of bleeding or a blocked stomach.
Because ZES is uncommon, getting a second opinion from a specialty center makes sense if tests are unclear or surgery is being considered. Genetic testing for MEN1 may be advised if you have a personal or family history of endocrine tumors.
If you want more reading, check our related articles on pancreatic conditions and digestive health on Family24Rx.com. For any new or worsening symptoms, talk to your doctor — early diagnosis usually makes treatment simpler and more effective.
