Gastrinomas present either in association with multiple endocrine neoplasia (30%) or sporadically (70%) in the remaining patients. Differences exist between the two types in terms of presentation, associated findings, and the ability to achieve biochemical and clinical cure. Duodenal gastrinoma is the most common location for both types, although some series have shown that MEN I is associated with a higher incidence of duodenal primaries. Although pancreatic adenomas (of any type) are more common in MEN I, pancreatic gastrinomas are more frequent in the sporadic form. Primary duodenal gastrinomas are also known to be a more frequent cause of Zollinger-Ellison (ZE) syndrome than previously thought. They are usually < 1 cm in size (smaller than pancreatic gastrinomas), located predominantly in the proximal portion of the duodenum (80%), and metastasize to regional lymph nodes in two-thirds of the patients.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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