What are the recommended treatment options for managing Zollinger-Ellison Syndrome in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended treatment options for managing Zollinger-Ellison Syndrome (ZES) in primary care focus on acid suppression therapy using proton pump inhibitors (PPIs). PPIs such as lansoprazole 30 mg, omeprazole 20–40 mg, esomeprazole 20 mg, pantoprazole 40 mg, or rabeprazole 20 mg are recommended to control gastric acid hypersecretion associated with ZES.

In primary care, management includes ensuring adherence to PPI therapy at the lowest effective dose to control symptoms and prevent ulcer complications.

Referral to specialist gastroenterology services is advised for further investigations and management if symptoms are refractory or recurrent despite optimal acid suppression, or if there is diagnostic uncertainty.

Additionally, it is important to exclude other causes of ulcer disease such as Helicobacter pylori infection and NSAID use, which should be managed accordingly.

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