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Gastroesophageal Reflux Disease in the Zollinger-Ellison Syndrome

JOEL E. RICHTER, M.D.; STEPHEN J. PANDOL, M.D.; DONALD O. CASTELL, M.D.; and DENIS M. MCCARTHY, M.D.
[+] Article and Author Information

Grant support: by Department of the Navy Clinical Investigation Program #0-06-1398.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or the Department of Defense.

▸Requests for reprints should be addressed to Joel E. Richter, M.D.; Box 163, Gastroenterology, National Naval Medical Center; Bethesda, MD 20014.


Ann Intern Med. 1981;95(1):37-43. doi:10.7326/0003-4819-95-1-37
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Gastroesophageal reflux has rarely been reported in the Zollinger-Ellison syndrome, presumably due to elevation in the lower esophageal sphincter pressure. We have evaluated 15 patients with the Zollinger-Ellison syndrome for evidence of esophageal disease. Five presented initially with esophageal disease: one, reflux symptoms; two, severe esophagitis; and two, strictures. Six of 15 had heartburn and nine of 15, objective evidence for reflux disease. Mean lower esophageal sphincter pressure was higher in the Zollinger-Ellison syndrome than in controls but was unrelated to serum gastrin levels. Zollinger-Ellison syndrome patients without heartburn had a higher mean sphincter pressure than did patients with heartburn (who had a mean sphincter pressure similar to that of controls but greater than that in patients with idiopathic gastroesophageal reflux). Four patients had biopsy evidence of esophagitis, one in association with Barrett's epithelium. Gastroesophageal reflux and its complications appear to be common in the Zollinger-Ellison syndrome.

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