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DEAR DR. DONOHUE: I have been told I have Zollinger-Ellison syndrome. I have ulcers and am on medication for them. I have poor results. Please tell me more about Z-E syndrome. - D.G.

ANSWER: This is not your run-of-the-mill ulcer story. It involves, first of all, a hormone (gastrin) that turns on stomach acid production. It also involves a tumor (a gastrinoma) that produces extra gastrin, stimulating the stomach to churn out great amounts of its acid. This causes the ulcers.Zollinger-Ellison ulcers are hard to treat. The goal is two-fold: to stop the stomach acid production and to find and get rid of the tumor. We have drugs to stop the acid production. Omeprazole is an example of a newer drug. Getting rid of the tumor is tougher. Finding it is difficult, and to complicate matters there may be more than one. And sometimes a tumor may spread.

To make things worse, we sometimes find that Z-E encompasses other problems involving different kinds of tumors of the pituitary and parathyroid glands. I've thrown enough at you for now. I am sure your doctors are trying to get to the root of your troubles. When they do, you will have better results from your control efforts. From my brief description of Z-E, you can understand why patience is a prime requisite for the patient with it. For discussion of ulcers in general, see the booklet on that. Order by writing Dr. Donohue/No.25, Box 19660, Irvine, CA 92713-0660, enclosing a long, stamped, self-addressed envelope and $2.

DEAR DR. DONOHUE: I have been under treatment for six years and get vitamin B-12 and iron injections regularly. I am diagnosed as having iron deficiency anemia. I am fatigued all the time. Do I need a second opinion? - Mrs. B.F.

ANSWER: I think it is time to get another opinion. Iron deficiency, if that's the problem, is rather easily curable. You give the person iron, then try to find out the cause of the deficiency. The same for B-12 deficiency.

As to the iron lack, a common cause is blood loss. Red blood cells store up iron. When you lose them, as women often do with excess menstruation, you lose iron reserves. Some women falsely accept heavy menstruation as normal for them. And in both men and women, an iron deficiency can reflect intestinal bleeding, which can be so subtle as to go unnoticed. Without prompt answers, and after years of apparently failed treatment, I say it is time for a second opinion.

DEAR DR. DONOHUE: Please explain chalazions. What causes them? What is the treatment? - M.G.

ANSWER: A chalazion is a growth on the inner surface of the eyelid where a gland has become blocked. The pedantic term for more than one chalazion is "chalazia." (Are you impressed?)

A chalazion may appear at first to be a sty, but on closer observation you find that it is deeper. Often, a chalazion may disappear on its own, while some get progressively worse and require removal by an eye surgeon.

DEAR DOCTOR: You mentioned male side effects from anabolic steroids (body-builder kind). What about females? Some use them. - J.

ANSWER: Female effects include facial hair, voice deepening, hair thinning, acne and mood changes. I want to stress, as you do, that anabolic steroids are not the common cortisone-type ones.


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