Zollinger-Ellison syndrome - stomach image

by Derek Matlock, PharmD

What is Zollinger-Ellison Syndrome?

Do you suffer from Zollinger-Ellison syndrome (ZES)? If so, you may be in rare company. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Zollinger-Ellison syndrome is a rare disorder. It occurs in about one in every 1 million people. Normally, when we eat, our body releases a hormone called gastrin, which tells your stomach to make acid to help break down foods and liquids. For patients with ZES, this mechanism is disrupted by tumors or “gastrinomas.” These tumors form in the pancreas or upper small intestine and secrete abnormally large amounts of gastrin from tumors, resulting in peptic ulcers to be formed.

It Might Be Your Genes

Some people with Zollinger-Ellison syndrome may go undiagnosed as the disorder is rare and its cause is not clear. In 75% of cases, ZES is sporadic or random, whereas in 25% it is associated with MEN 1, an inherited condition characterized by pancreatic endocrine tumors, pituitary tumors, and hyperparathyroidism.  Therefore, your doctor may perform a thorough medical and family history to help diagnose ZES. Additional tests may include endoscopy or various imaging and blood tests. They may even measure the amount of acid in your stomach. For patients with sporadic ZES, the most common symptom is abdominal pain. While patients with the inherited form of ZES mostly complain of diarrhea. Other symptoms include, heartburn, nausea, vomiting, stomach bleeding, and weight loss.

Managing Zollinger-Ellison Syndrome

Currently, the goal of managing ZES is to limit complications of the disorder by suppressing acid secretions. Thus, the main medications used in ZES are proton pump inhibitors, or PPIs, like omeprazole (Prilosec®) or pantoprazole (Protonix®), prescribed at high doses. For patients who do not respond to treatment with PPIs, octreotide is used, which stops the secretion of gastrin, the hormone that tells our body to secrete acid for food breakdown. Currently, the only cure for ZES is surgical removal of the tumor or tumors, but this may not be an option in cases where the tumors have spread to other parts of the body. In that case, chemotherapy with medications like streptozotocin, 5-fluorouracil, and doxorubicin are used to shrink tumors.

Zollinger-Ellison syndrome is a rare disorder that may be suspected in patients with multiple or repeat peptic ulcers. Currently, medications like proton pump inhibitors are the main treatment option, while surgery and chemotherapy are options in certain patients. Remember, when taking proton pump inhibitors, they are best taken 30-60 minutes before a meal and may also come with their own unfavorable side effects. Be sure to talk to your doctor or pharmacist about what can be done to best optimize your treatment options for ZES.


  1. Medscape: Zollinger-Ellison Syndrome
  2. National Institute of Diabetes and Digestive and Kidney Diseases: Zollinger-Ellison Syndrome
  3. UpToDate: Management and Prognosis of the Zollinger-Ellison Syndrome

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Photo of feet at pool needing sunscreen

Now that summer is just around the corner, it is important to start thinking about extra protection from the damaging rays of the sun. Sunscreen is fundamental for everyone all year, but protection from the sun is especially important during the summer for those who enjoy summer activities such as laying out by the pool, going to the beach or attending summer picnics in the park. Although being in the sun can be enjoyable, once the sun starts to sting your skin, it is a reminder of how important it is to spread on that extra protection.

It is recommended to use sunscreen not only during sun exposure, but also on cloudy or cool summer days. Consequences of sun damage include sunburns, premature aging of the skin, premature skin wrinkling and skin cancer including melanoma.

How Does Sunscreen Work?

Sunscreen works by reflecting, adsorbing or scattering sunlight. There are numerous brands and varieties claiming sun protection, but it is important to choose the correct type. The Centers for Disease Control and Prevention (CDC) recommends a protection level of SPF 15 that includes both UVA and UVB protection. If you are in the sun continuously for two hours, it’s recommended that you reapply sunscreen. It is also recommended to reapply it after swimming and/or sweating.

To get the best results from your sunscreen, apply generously at least 15 minutes before going outdoors. Don’t forget to put sunscreen to your back, ears, nose, lips, the back of your neck and even the tops of your feet.

In combination with using sunscreen, it is also important to take other measures to protect exposed skin from the sun. Seek shade when possible, wear a wide brim hat and wear sunglasses that offer UVA and UVB protection. You should wear loose fitting long sleeve shirts and long pants made from tightly woven fabric if possible.

How Long Should I Keep Sunscreen?

Sunscreens are designed to remain at their original strength for up to three years. This means you can use leftover sunscreen from one year to the next. It’s important to check expiration dates on your sunscreen. If the sunscreen is exposed to high temperatures, the shelf life may decrease. When you can, store sunscreen away from heat and sun, and if it’s past the expiration date, it’s time to throw it out.

Some people may have an allergic reaction to sunscreen. Some reactions may include itching or rash. If you experience these types of reactions, try another brand of sunscreen or call your doctor.


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Saving on medication prices with the ScriptSave WellRx app

Nancy went to the pharmacy to pick up her medications and was shocked when she heard her total was $211 for her medications. Why are prescriptions so expensive? It’s staggering. We get it.

It has become more and more difficult to put the words “affordable” and “healthcare” in the same sentence in the United States. Prescription medications composed 16.7% of all U.S. healthcare spending in 2015. From 2006 to 2013, prescription drug costs went up 174% in America.1

Rising Medication Prices - Price of Therapy per Prescription Drug
Chart source: https://www.fool.com/investing/general/2016/03/26/prescription-drug-prices-have-doubled-in-just-7-ye.aspx

You may be wondering, how is this possible? What can I do about this? Well, let’s study the chart below and take a look at some numbers.

Nancy has 4 new prescriptions she has to pick up since being discharged from the hospital:

Rising Medication Prices - Cost of prescription medications without ScriptSave WellRx

$211?! How is this pricing even possible? Nancy can do 2 things here: She can pay it upfront and she will likely try to make it last by taking her medication every other day instead of daily. This may lead to problems down the road as she is sacrificing her health due to medication costs. Her other option would be to decide not to pay it at all which may lead to her being re-admitted into the hospital. These are both real problems.


She could pull out the handy ScriptSave WellRx app to help her find ways to save money on her prescription medication expenses. She types in all her medications into the app and finds:

Rising Medication Prices - Lower prescription prices using ScriptSave WellRx

In just a few minutes, Nancy is able to find a local pharmacy with the affordable prescription medication costs. All Nancy has to do is whip out her mobile device, pull up her prescription savings card on the app, and show it to the pharmacist. In just a few moments, the pharmacist can use the prescription savings card to give Nancy additional cost savings!

ScriptSave WellRx (Andriod/iOS) provides cost savings on prescription medications for every member of the household, including pets. It is incredibly easy to use and can provide cost savings on both generic and brand-name medications. It is convenient, effective, and all it took is one mobile app to save some money. Try this high-tech, no-risk way to save on your pain medications, antibiotics, allergy relief or any other prescriptions—check out our Medication Search to find the lowest price for your prescription now. You might be surprised at how much you save!