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Treatments and drugs
By Mayo Clinic staffIn treating Zollinger-Ellison syndrome, doctors focus first on the tumors and then on the ulcers.
Treatment of tumors
An operation to remove the tumors that occur in Zollinger-Ellison requires great skill because the tumors are often small and difficult to locate. If you have just one tumor, your doctor may be able to remove it surgically, but surgery may not be an option if you have multiple tumors or tumors that have spread to your liver. On the other hand, even if you have multiple tumors, your doctor still may recommend removing a single large tumor.
In some cases, doctors advise other treatments to control tumor growth, including:
- Removing as much of a liver tumor as possible (debulking)
- A liver transplant
- Attempting to destroy the tumor by cutting off the blood supply (embolization) or by using heat to destroy cancer cells (radiofrequency ablation)
- Injecting drugs into the tumor to relieve cancer symptoms
- Using chemotherapy to try to slow tumor growth
More radical surgical approaches, such as severing the nerves that promote acid secretion or removing the entire stomach, aren't generally done today because medications are usually successful in controlling acid production and ulcers.
Treatment of excess acid
Today, excess acid production can almost always be controlled. Medications known as proton pump inhibitors are the first line of treatment. These are the most effective medications for decreasing acid production in Zollinger-Ellison syndrome. Proton pump inhibitors are powerful drugs that reduce acid by blocking the action of the tiny "pumps" within acid-secreting cells. Commonly prescribed medications include lansoprazole (Prevacid), omeprazole (Prilosec), pantaprazole (Protonix), rabeprazole (Aciphex), and esomeprazole magnesium (Nexium).
Previously, medications called histamine (H-2) blockers were used, but these medications don't work as well as proton pump inhibitors do in treating the ulcers of Zollinger-Ellison syndrome.
Your doctor may also suggest one of several operations to treat peptic ulcers. This may include surgery to:
- Stop an ulcer from bleeding
- Relieve an obstruction caused by an ulcer
- Close up the hole (perforation) that an ulcer has made in the wall of your stomach or duodenum
