26-year-old woman. Year of heartburn, chest pain, palpitations, and a meal-linked cascade to presyncope. EKG and echo negative. Large hernia, reflux esophagitis, IEM, pathologic pH. Roemheld: GI driver, cardiac-like symptoms, exclusion diagnosis.
Gastrin 1000. Referred as gastrinoma.
It was Type I — autoimmune atrophic gastritis, not Zollinger–Ellison.
NBI cannot split Type I from Type II. Labs can.
Type III is the solitary >1 cm lesion you do not under-stage.
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