Zollinger-Ellison Syndrome

What is Zollinger-Ellison syndrome?

Zollinger-Ellison syndrome (ZES) is a rare digestive disorder. If you have ZES, you likely have one or more tumors in the first part of the small intestine, the pancreas, or both. These tumors are called gastrinomas. They release the hormone gastrin. This causes the stomach to release too much acid. Stomach acid is needed to break down food. But too much acid can cause painful peptic ulcers inside the lining of your stomach and intestine. While gastrinoma tumors do cause health problems, they are typically not cancerous tumors.  

What causes Zollinger-Ellison syndrome?

ZES is caused by tumors, called gastrinomas. The tumors cause the release of too much stomach acid. The extra acid can cause painful peptic ulcers inside the lining of your stomach and intestines.

Who is at risk for Zollinger-Ellison syndrome?

Just about anyone can get ZES. But, some people with the condition may have a genetic problem known as multiple endocrine neoplasia type 1 (MEN1).  Children of adults with MEN1 are at an greater risk of getting the disease. ZES is more common in men, often those 30 to 50 years old.

What are the symptoms of Zollinger-Ellison syndrome?

The symptoms of ZES are similar to those of other ulcers. They include:

  • Nausea
  • Vomiting
  • Weight loss
  • Diarrhea
  • Abdominal pain, sometimes burning in nature
  • Severe heartburn (gastroesophageal reflux disease or GERD)
  • Intestinal bleeding such as black or tarry stool, or blood in the stool

How is Zollinger-Ellison syndrome diagnosed?

If you have the symptoms associated with ulcers or ZES, your healthcare provider may measure your stomach acid levels. He or she may also give you a blood test to measure your level of the hormone gastrin, to see whether your body makes too much. Your healthcare provider may order imaging tests to look for tumors.

How is Zollinger-Ellison syndrome treated?

Medicines called proton pump inhibitors can help manage the extra stomach acid. These medicines help to stop ulcers from developing.

In some cases, you need surgery to remove tumors in your digestive tract. In the most severe cases, your doctor may give you chemotherapy to destroy them. This might be when tumors have spread to other parts of your body.

What are possible complications of Zollinger-Ellison syndrome?

In most people with ZES, tumors grow slowly and don’t spread quickly. If you can manage the ulcers, you can enjoy a good quality of life. The 10-year survival rate is very good, although a few people do get more serious disease.

When should I call my healthcare provider?

ZES can sometimes be serious with severe complications if not treated. See your healthcare provider for a diagnosis if any of the symptoms last for more than a few days. Call your provider if you have any signs of intestinal bleeding, such as black or tarry stool, blood in the stool, or vomiting of blood.

Key points about Zollinger-Ellison syndrome

  • Zollinger-Ellison syndrome is a rare digestive disorder that results in too much gastric acid.
  • This extra gastric acid can cause peptic ulcers in your stomach and intestine.
  • Symptoms include abdominal pain, nausea, vomiting, weight loss, and diarrhea.
  • If left untreated, there can be serious complications.
  • Treatment may include medicines and sometimes surgery.


GERD (Gastroesophageal Reflux Disease)
GERD (Gastroesophageal Reflux Disease)
Want More Information?

Cedars-Sinai has a range of comprehensive treatment options.

Looking for a Physician?

Choose a doctor and schedule an appointment.

Need Help?


Available 24 Hours A Day