Monitoring
In order to prevent complications of increased gastric acid secretion, it has previously been recommended that gastric acid output be controlled to <10 mEq/hour in patients with sporadic Zollinger-Ellison syndrome, and <5 mEq/hour in patients who have multiple endocrine neoplasia type 1 syndrome.[1][44] However, acid secretory studies are often not available and in most cases proton-pump inhibitor therapy is initiated at an empirical maximised dosage.[18] Once symptoms are well controlled, the dose may be safely reduced in increments to about 50% of the starting dose.[1][54]
Patients should be evaluated for recurrence with fasting serum gastrin, secretin test, and imaging annually or semi-annually.
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