Abstract
Gastrin is an important hormone of the digestive system, which assists gastric acid secretion. It may be pathologically elevated in conditions such as Zollinger-Ellison syndrome, or due to common medications such as proton pump inhibitors. In this review we provide an overview of the pathophysiology and medical causes of hypergastrinemia, diagnostic testing and clinical consequences of chronic hypergastrinemia.
Highlights
Gastrin is one of the most important and clinically relevant hormones of the digestive system and has been studied extensively for the past decade
In this review we provide an overview of the pathophysiology and medical causes of hypergastrinemia, diagnostic testing and clinical consequences of chronic hypergastrinemia
It is necessary to monitor gastrin levels in a few conditions, including (i) refractory or recurrent peptic ulcer disease (PUD) in the absence of non-steroidal anti-inflammatory drugs or helicobacter pylori (H. pylori) infection, (ii) PUD in unusual locations, (iii) PUD with concurrent endocrinopathies, (iv) gastroesophageal reflux disease (GERD) refractory to proton pump inhibitors (PPIs) and/or with distal esophageal strictures, (v) presence of prominent rugal folds seen on upper endoscopy, (vi) chronic secretory diarrhea and (vii) gastric carcinoids
Summary
Gastrin is one of the most important and clinically relevant hormones of the digestive system and has been studied extensively for the past decade. It is necessary to monitor gastrin levels in a few conditions, including (i) refractory or recurrent peptic ulcer disease (PUD) in the absence of non-steroidal anti-inflammatory drugs or helicobacter pylori (H. pylori) infection, (ii) PUD in unusual locations (e.g. beyond the duodenal bulb), (iii) PUD with concurrent endocrinopathies, (iv) gastroesophageal reflux disease (GERD) refractory to proton pump inhibitors (PPIs) and/or with distal esophageal strictures, (v) presence of prominent rugal folds seen on upper endoscopy, (vi) chronic secretory diarrhea and (vii) gastric carcinoids In these clinical conditions with abnormal gastrin production, it is important to check for abnormal gastrin levels and to look for the source, if elevated. Quantification of gastric acid secretion can determine whether or not the elevated gastrin is an appropriate response, and will influence further test and therapy
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