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Sensitive stomach, on prilosec, negative for H. pylori and celiac disease, vomiting, no appetite. Is it Zollinger-Ellison?

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Gastroenterologist, Surgical
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Is it Zollinger-Ellison please help!!
I am 29 year old woman. Ever since I can remember I have had a "sensitive" stomach. For years I thought it was just stress as well as most of my doctors. I was put on prilosec as a teenager and back then it was prescribed...not OTC. I would have issues off and on throughout my life. I've never been able to drink much because my stomach doesn't tolerate it. I don't take aspirin or any NSAIDS as they too have upset my stomach and make me sick. My symptoms have gotten drastically worse in the last two years. Originally my Doctor and I thought it was just stress because I lost my husband to suicide and months later I lost my son to cancer but my symptoms were persistent. I started having diarrhea badly and vomiting almost daily. I had a scope done and it showed severe gastritis with a small ulcer. I was put on nexium results for H. Pylori were negative. Symptoms improved but only for a couple of weeks. Once again I am vomiting and no appetite. I have lost over 30lbs without trying. 6 months after the first scope I just had another one done. This showed that in less then 6 months I now have 6 large ulcers, but none in the duodenum. Biopsies were negative once again for H. pylori and celiac disease. Doctor has me do a fasting gastrin test. It came back elevated at 1045. My doctor then told me about ZES. They want me to re-do the gastrin test after being off of nexium because I had started taking it 5 days before my test. My question is can taking nexium for 5 days elevate your gastrin levels that much that fast? Also if not ZES what is another likely cause?? I am in treatment but can never get answers fast enough!!! Please help.
Posted Tue, 22 May 2012 in Digestion and Bowels
Answered by Dr. Ajit Naniksingh Kukreja 23 hours later

Thanks for posting your query

My first word is a word of appreciation for the courage you have shown at a tender age

Here are some facts about Zollinger Ellison Syndrome {ZES}

Zollinger-Ellison syndrome is a condition in which there is increased production of gastrin.

Usually, a small tumor (gastrinoma) in the pancreas or small intestine produces the high levels of gastrin in the blood.

Though a good number of symptoms and signs that you have relate to ZES, it is definitely better to get a second Gastrin Level done

Following may help rule out ZES :

Gastrin blood level

Abdominal CT scan

Endoscopic ultrasound

Your doctor wants you to be off Nexium because it is a part of treatment of ZES, so if you are on ZES there can be false interpretation of the results

If the second level of Gastrin also turns high, go for the investigations I have suggested in a phase wise manner and get back to me

Hope this helps
Wishing you a speedy recovery, And keep your moral high
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