Zollinger-Ellison syndrome pathophysiology
ZES pathophysiology
Zollinger-Ellison syndrome (ZES) is caused by a non–beta islet cell, gastrin-secreting tumor of the pancreas that stimulates the acid-secreting cells of the stomach to maximal activity.
The symptoms of Zollinger-Ellison syndrome (ZES) are due to hypergastrinemia, it causes hypertrophy of the gastric mucosa, leading to increased numbers of parietal cells and increased acid output.
Gastrin also stimulates acid secretion, resulting in increased basal acid secretion. This excessive acid secretion leads to gastrointestinal mucosal ulceration. It also causes diarrhea and malabsorption.
Malabsorption in ZES usually due to
- Direct mucosal damage due to acid
- Inactivation of pancreatic enzymes due to acidic pH (pancreatic enzyme works in Alkaline pH)
- Precipitation of bile salts due to acidic pH
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