{"id":2482,"date":"2009-03-08T23:31:36","date_gmt":"2009-03-08T23:31:36","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gaszes\/"},"modified":"2025-05-14T19:09:50","modified_gmt":"2025-05-14T19:09:50","slug":"gaszes","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gaszes\/","title":{"rendered":"Diagnostic Criteria for Zollinger-Ellison Syndrome (ZES)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Zollinger-Ellison (ZES) syndrome is characterized by gastric acid hypersecretion resulting in severe acid-related peptic disease and diarrhea.<!--more--><\/p>\n<p class=\"MsoNormal\">Diagnostic criteria for ZES include the following:<\/p>\n<ol style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\">Elevated levels of Basal Acid Output (BAO), greater than 15 mEq in unoperated patients and greater than 5 mEq if previous acid-reducing surgery has been performed;<\/li>\n<li class=\"MsoNormal\">Elevated level of fasting serum gastrin (&gt;100 pg\/mL until 1994, &gt;200 pg\/mL since 1994);<\/li>\n<li class=\"MsoNormal\">Abnormal results from stimulation testing with secretin (an increase of &gt;200 pg\/mL postinjection) or with calcium (an increase &gt;395 pg\/mL);<\/li>\n<li class=\"MsoNormal\">Positive histologic confirmation of gastrinoma; or<\/li>\n<li class=\"MsoNormal\">A combination of these criteria.<\/li>\n<\/ol>\n<p class=\"MsoNormal\">The tests used most commonly to establish a diagnosis of ZES are the fasting serum gastrin concentration and BAO evaluation. Measurement of gastric pH is important to exclude achlorhydria as a cause of secondary hypergastrinemia. Patients taking Proton Pump Inhibitors (PPIs), those who have undergone massive small bowel resection, or those who have renal insufficiency, G-cell hyperplasia, or gastric outlet obstruction may have gastrin levels between 150 and 1000 pg\/mL Hence, for patients with suspected ZES with an equivocal fasting serum gastrin concentration, a secretin stimulation test should be performed.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\">Gibril F, Schumann M, Pace A, Jensen RT. Multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome: a prospective study of 107 cases and comparison with 1009 cases from the literature. Medicine (Baltimore). 2004;83:43-83. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/14747767\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Jun 21, 2005<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[16,15,14,13,1465,1413,5,4,1464,1466],"class_list":["post-2482","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-ellison","tag-gastroenterology","tag-sindrome","tag-syndrome","tag-zes","tag-zollinger"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2482","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2482"}],"version-history":[{"count":2,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2482\/revisions"}],"predecessor-version":[{"id":8987,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2482\/revisions\/8987"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2482"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2482"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2482"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}