To the Editor:—
A patient who presented with diarrhea, vague abdominal distress, and no demonstrable ulcer by x-ray film was lated found to have the Zollinger-Ellison syndrome. The empiric use of a magnesium-aluminum hydroxide suspension (Maalox) for relief of abdominal distress also relieved the diarrhea. This commonly used antacid combination of magnesium and aluminum hydroxide ordinarily exerts a laxative effect. The paradoxical antidiarrheal response to magnesiumaluminum hydroxide suspension offers a diagnostic clue to the Zollinger-Ellison syndrome.
Report of a Case:—
This 19-year-old male was seen in April 1968 with a tenmonth history of diarrhea of six watery stools a day, abdominal cramping, nausea, and 20-lb weight loss. An upper gastrointestinal tract series was normal, but clumping and segmentation of barium was present in the small bowel. Triolein I 131 absorption was diminished to 7%. Barium enema x-ray films, proctoscopic examination, and stool cultures and examinations for ova and parasites showed