Review Article: Strategies to Determine Whether Hypergastrinaemia Is Due to Zollinger-Ellison Syndrome Rather Than a More Common Benign Cause

S.V.M. Murugesan; A. Varro; D.M. Pritchard


Aliment Pharmacol Ther. 2009;29(10):1055-1068. 

In This Article


As there is considerable overlap in the fasting serum gastrin concentration found in ZES and more common benign conditions, we aimed to (1) define the clinical causes of hypergastrinaemia; (2) review the association between hypergastrinaemia and two common clinical scenarios, namely acid suppressing medication use and H. pylori infection; (3) define the role of various non-invasive investigations that can be used to establish the cause of hypergastrinaemia and (4) develop an algorithm for the subsequent investigation of patients with elevated (mild-to-modest) fasting serum gastrin concentrations in whom the clinical diagnosis is unclear. We aimed to review predominantly more recent evidence, particularly that published over the last decade.