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Tests and diagnosis
By Mayo Clinic staffBesides reviewing your medical history and asking about your signs and symptoms, your doctor may recommend the following diagnostic procedures:
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Blood tests. A sample of your blood is analyzed in a laboratory to see whether you have an increased gastrin level in your blood. An elevated gastrin level may indicate tumors in your pancreas or duodenum. This test needs to be done on an empty stomach, so you'll have to fast prior to this test. Also, you may need to stop taking any acid-reducing medications to get the most accurate measure of your gastrin levels. Additionally, because gastrin levels can fluctuate, this test will likely need to be repeated at least three times.
Elevation of gastrin can also occur if the stomach doesn't make acid, which can occur if you have chronic inflammation of the stomach or have had surgery on your stomach. This condition can be confused with Zollinger-Ellison because gastrin levels can get quite high. Your doctor may test the acidity of the stomach to clarify which condition is elevating your gastrin levels. If the stomach isn't acidic, then Zollinger-Ellison is unlikely. If your stomach makes acid, your doctor may perform a secretin stimulation test. For this test, your doctor measures your gastrin levels, and then gives you an injection of the hormone secretin. Another measurement of gastrin levels is then taken. If you have Zollinger-Ellison, your gastrin levels will increase even more.
- Upper gastrointestinal endoscopy. After you've been sedated, your doctor inserts a thin, flexible instrument with a light and video camera (endoscope) down your throat and into your stomach and duodenum to look for ulcers. Through the endoscope, your doctor may remove a tissue sample (biopsy) from your duodenum for examination in the laboratory to help detect the presence of gastrin-producing tumors. To prepare for the test, your doctor will ask you not to eat anything after midnight the night before the test.
- Imaging studies. In order to pinpoint the location of tumors, your doctor may use imaging techniques such as a nuclear scan — which uses radioactive tracers to help locate tumors — computerized tomography (CT), ultrasound imaging, or magnetic resonance imaging (MRI).
- Endoscopic ultrasound. In this procedure, your doctor examines your stomach and duodenum with an endoscope fitted with an ultrasound probe. The probe allows closer imaging of the digestive tract, making it easier to spot tumors. It's also possible to remove a tissue sample through the endoscope. You'll need to fast after midnight the night before this test, and you'll be sedated during the test.
