Gastroesophageal Reflux Disease in the Zollinger-Ellison Syndrome

Abstract

Gastroesophageal reflux was rarely reported in the Zollinger-Ellison syndrome, presumably due to an elevation in the lower esophageal sphincter pressure. Fifteen patients with Zollinger-Ellison syndrome were evaluated for evidence of esophageal disease. Five initially were presented with esophageal disease. Six of 15 had heartburn and 9 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, 1 in association with Barrett''s epithelium. Gastroesophageal reflux and its complications are apparently common in the Zollinger-Ellison syndrome.