Reflux esophagitis in patients with Zollinger-Ellison syndrome

Gastroenterology. 1990 Feb;98(2):341-6. doi: 10.1016/0016-5085(90)90823-j.


The incidence of ulcers of the stomach and duodenum and their response to medical therapy, in patients with Zollinger-Ellison syndrome is well described. However, reflux esophagitis is less well recognized. In this study we determined the frequency of reflux esophagitis in 122 patients with Zollinger-Ellison syndrome and examined their response to medical therapy. Esophageal symptoms, endoscopic abnormalities, or both were present in 61% of patients. Forty-five percent of patients had esophageal symptoms consisting of heartburn, dysphagia, or both. Forty-three percent of patients had endoscopic abnormalities of the esophagus, and 23% demonstrated moderate or severe disease. When sufficient antisecretory medication was administered to lower gastric acid secretion to less than 10 mEq/h in the last hour before the next dose of drug, 67% of the patients with reflux esophagitis responded with complete disappearance of symptoms and normalization of the endoscopic abnormalities. The other 33% of patients required an increase in medication to lower acid output to less than 5 mEq/h in 7% and less than 1 mEq/h in the other 26% to resolve symptoms and signs completely. We conclude that reflux esophagitis occurs in the majority of patients with Zollinger-Ellison syndrome and responds well to medical therapy, although one third of patients require intensive antisecretory medication.

MeSH terms

  • Adult
  • Aged
  • Esophagitis, Peptic / drug therapy
  • Esophagitis, Peptic / etiology*
  • Female
  • Histamine H2 Antagonists / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use
  • Parasympatholytics / therapeutic use
  • Zollinger-Ellison Syndrome / complications*


  • Histamine H2 Antagonists
  • Parasympatholytics
  • Omeprazole