Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Serum Grastrin Result

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Ulcer


Hello:

I've posted a couple of messages in the past and you have been very helpful in your information. I will be brief in my history. Two years ago I was treated with Flagyl and Biaxin following a positive H. Pylori blood test. Pain later returned and I recently had an EGD which showed severe peptic ulcer disease and a positive CLOtest. There was severe duodenitis and flecks of blood all over as well. I finished two weeks ago Helidac Therapy and since then have had two painful episodes with one lasting four days. My GE's chart notes said that due to the severity of the condition he was ordering a serum gastrin level for possible ZE Syndrome. I inquired several times as to the results of this, but his office never returned my calls. He put me on Zantic 150mg, twice a day and suggested no further followup testing after I asked what his plan was. I picked up my hospital chart today and have the results of that test. The Gastrin result was 99 and their referance range was <91. Also, the fasting gastric pH. was 1.5 Please tell me if I need to pursue followup treatment or further testing. Due to insurance red tape, I have to change networks in my HMO and am starting with a new GE in three weeks. These results mean nothing to me as I know I am not qualified to interpret them, but need to know what to do. FYI, I am a 41 year old female, 118 lbs, non-smoker, non-drinker and do not take NSAID's - just Tylenol if needed. Thanks again for your guidance.

____
Dear Dee,
Patients with ZE usually have serum gastrin levels in the range of several hundred to thousands. The miniaml elevation that you report could be the reult of a cid suppression with an H2 receptor anatgonist. The fasting pH is low, but it is difficult to know what this means. There are unusal causes for increased acid secretion e.g. systemic mastocytosis, bit these conditions are exceedingly rare. A detailed review of your record is necessary before making additional suggestions.

This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.

HFHSM.D.-rf
*keywords: ulcer, Zollinger Ellison syndrome
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