What is it?
A condition characterised by a rare type of duodenal ulcer resistant to conventional medical treatment. The root problem lies not in the duodenum - the upper part of the small intestine - but in the pancreas, where a tumour is producing high levels of gastrin, the hormone that regulates the production of stomach acid. The resulting excess of acid is what causes the ulcers.
How is it diagnosed?
By the persistence of ulcers after a normal course of treatment. The absence of Helicobacter pylori, the bacterium that is the usual cause of ulcers, is another key pointer. Exploration of the gut with an endoscope, a camera lens mounted on the end of a thin tube, may reveal severe ulceration far down the gut. Gastrin levels can also be determined: the higher they are, the more likely the diagnosis.
What is the treatment?
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High-dose antacids, with the aim of controlling the excess acidity. Surgery may also be required to remove the gastrin-secreting tumour. Long-term survival rate is good but depends on whether any malignancy has spread from the pancreas to other parts. For more information, see tinyurl.com/mnqmtp.