Frequently Asked Questions - Symptoms and Manifestations
Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. It is characterized by malabsorption due to loss of small intestinal surface area. The degree and type of resulting nutritional deficiencies depend on the length and location of the bowel that is lost. In general, patients will develop symptoms of short bowel syndrome when less than 200 cm of functional small bowel remains. As the majority of nutrient digestion and absorption is complete within the first 100 cm of jejunum, most patients will be able to maintain nutritional balance using oral feeding if at least 100 cm of intact jejunum is still present. Patients with less than 100 cm will likely require parenteral nutrition.
Simply tell your doctor you have read of the urine 5-HIAA as a measure of carcinoid tumor function and you want it done.
Flushing and diarrhea. A carcinoid tumor somewhere in the body, which has spread to the liver, produces serotonin, chromogranin A and other substances and usually results in excretion in the urine of increased amounts of 5-HIAA, the breakdown product of serotonin.
Carcinoid flush means experiencing a usually abrupt feeling of heat in the face which turns red in appearance. Sometimes, in women, the episodes are confused with hot flashes of menopause which unlike carcinoid flush often are accompanied by hot or cold sweat.
Diarrhea is defined as an increase in volume and /or frequency of stools. The consistency need not be loose, though it often is.
Serotonin and the other usual products of carcinoids do not stimulate the thyroid or the adrenal glands. However, on rare occasions a carcinoid can co-produce other hormonal substances in addition to serotonin and chromogranin A. These could be TSH or catecholes like epinephrine or norephinephrine. Also, in rare cases a carcinoid develops in an individual with the MEN I syndrome who also has one or more other endocrine tumors which could produce TSH, epinephrine or a number of other active hormones.
There are many possible causes of edema in association with carcinoid involving the liver. These include: low serum albumin due to carcinoid impairing the liver's synthetic function, impaired liver function due to chemotherapy, interference with circulation to or from the liver by pressure of carcinoid tumor on the blood vessels or from clotting of blood in the vessels due to substances released by the tumors, congestive failure of the right side of the heart due to carcinoid heart valve disease, pellagra due to tryptophan deficiency resulting from the tumors abnormal utilization of tryptophan, malabsorption due to hormone-induced small intestine pathophysiology, peritoneal spread of carcinoid tumor, retroperitoneal spread of carcinoid tumor with lymphatic obstruction, and a number of other possible causes. The treatment in each instance is somewhat different and hence must be customized for each case. The edema is not a separate disease but part of the entire carcinoid disease spectrum.
It sounds like you are describing ascites, the accumulation of fluid in the abdominal cavity. This is not exclusive for carcinoid disease but can occur in many conditions such as cirrhosis of the liver, heart failure, any widespread intra-abdominal cancers or various conditions compressing and blocking the lymph channels and/or large veins in the back of the abdominal cavity, as well as certain infections of the peritoneum (the lining of the abdominal cavity). The treatment and significance in each instance is different.
Carcinoid Cancer Foundation
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