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Gastroenterology (Expert Forum)
Are these all symptoms of carcinoid syndrome/
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Are these all symptoms of carcinoid syndrome/
by harry100, Jun 27, 2004 12:00AM
I'm a 42 yr old Female, fairly healthy. In the last 8-9 mos, I haven't felt "right". It started with light palpataions and intensified to breathing difficulties/chest pains at times. I got my heart checked-stress test, EKG, and ultrasound in December-all was well, just a slight murmur. Okay,I took the answer and went home.
In March,I had what the Drs & hospital thought was an anxiety attack, but definitely not a heart attack. It started suddenly with pressure in my chest, shoulder, and up into my neck/teeth and ear. I had overall flushing of sweats/chills along explosive diarrhea and repeated vomiting. It was very difficult to get the vomiting under control After blood, urine, xrays etc, I was sent home with no answers. Nonetheless it was attack #1. So f/up w/ the Primary says I have high blood pressure and anxiety. Okay-I take the answer and medicine and go home.
In April, attack #2, the same things, heavy pressure just above my stomach-right between the ribs. Again with the sudden overall flushing all over again. The breathing difficulty was much more intense. I was extremely, extremely ill with diarrhea and vomiting, worthy of a 6-day hospital stay. I was poked, scoped and scanned in every direction. The only findings, are what I would say, not even significant to my illness; esophagael erosion, slight ulcer, diverticulosis and a little bit of hemmorhoids. Still the only answer was the good old infamous guess and blanket statement... it must be a viral infection. Okay, so I take that and go home, to a 3 week recovery to replace my ilium lining. I never want to get that sick again.
Six weeks later-I have another attack,#3,out of nowhere, same thing. BP Shot up to 171/101, diarrhea, sweats and chills, vomiting and pressure in the upper chest almost into my neck/throat. After I blew out in every direction, and laid down for a while, it passed. I don't know why this one passed so quickly.
My primay is sending me to an endocronologist now to rule out carcinoid syndrome. Of course, I couldn't get an appt until the end of July and that was instead of November!! I just had an Octreocide scan series and now I'm working on the two 24-hour urine collection tests.
I was checking into the carcinoid syndrome, but nowhere does it say anything about vomiting. At this point I'm a little apprehensive to eat or go more than 10 minutes away from a toilet.
Are we looking in the right direction??
The only info I could think to add, relative or not, is that i may be becoming menopausal. About 2-3 years ago I pulled a groin muscle that gets a little aggravated at times. Also about 7-8 yrs ago, I had was dumb enough to dive into a stream, and hit a tree, causing extensive facial tears and body trauma, including major bruising/lumps (I still have a lump today)to the chest/sternum area.
The only cancer history is my paternal side-prostate.
I appreciate and thank you in advance for your thoughts and considerations, anything helps. Thank you.
In March,I had what the Drs & hospital thought was an anxiety attack, but definitely not a heart attack. It started suddenly with pressure in my chest, shoulder, and up into my neck/teeth and ear. I had overall flushing of sweats/chills along explosive diarrhea and repeated vomiting. It was very difficult to get the vomiting under control After blood, urine, xrays etc, I was sent home with no answers. Nonetheless it was attack #1. So f/up w/ the Primary says I have high blood pressure and anxiety. Okay-I take the answer and medicine and go home.
In April, attack #2, the same things, heavy pressure just above my stomach-right between the ribs. Again with the sudden overall flushing all over again. The breathing difficulty was much more intense. I was extremely, extremely ill with diarrhea and vomiting, worthy of a 6-day hospital stay. I was poked, scoped and scanned in every direction. The only findings, are what I would say, not even significant to my illness; esophagael erosion, slight ulcer, diverticulosis and a little bit of hemmorhoids. Still the only answer was the good old infamous guess and blanket statement... it must be a viral infection. Okay, so I take that and go home, to a 3 week recovery to replace my ilium lining. I never want to get that sick again.
Six weeks later-I have another attack,#3,out of nowhere, same thing. BP Shot up to 171/101, diarrhea, sweats and chills, vomiting and pressure in the upper chest almost into my neck/throat. After I blew out in every direction, and laid down for a while, it passed. I don't know why this one passed so quickly.
My primay is sending me to an endocronologist now to rule out carcinoid syndrome. Of course, I couldn't get an appt until the end of July and that was instead of November!! I just had an Octreocide scan series and now I'm working on the two 24-hour urine collection tests.
I was checking into the carcinoid syndrome, but nowhere does it say anything about vomiting. At this point I'm a little apprehensive to eat or go more than 10 minutes away from a toilet.
Are we looking in the right direction??
The only info I could think to add, relative or not, is that i may be becoming menopausal. About 2-3 years ago I pulled a groin muscle that gets a little aggravated at times. Also about 7-8 yrs ago, I had was dumb enough to dive into a stream, and hit a tree, causing extensive facial tears and body trauma, including major bruising/lumps (I still have a lump today)to the chest/sternum area.
The only cancer history is my paternal side-prostate.
I appreciate and thank you in advance for your thoughts and considerations, anything helps. Thank you.
Doctor's Answer
by Kevin Pho, MD, Jun 28, 2004 12:00AM
, Jun 28, 2004 12:00AM
The symptoms of diarrhea and flushing can be suggestive of carcinoid syndrome. It is likely that the urine is being tested for 5-hydroxyindoleacetic acid (HIAA) which can be suggestive of the disease. The endocrinology referral is a reasonable next step.
If you haven't had a colonoscopy this should certainly be considered.
Non-GI causes can include cardiac disease. A stress test and/or echocardiogram would be reasonable tests to evaluate for any structural heart conditions as well as any blockages in the coronary arteries (although the latter option would be less likely in your age group). Still, cardiac causes should still be considered in light of your elevated blood pressure as well.
These considerations can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
If you haven't had a colonoscopy this should certainly be considered.
Non-GI causes can include cardiac disease. A stress test and/or echocardiogram would be reasonable tests to evaluate for any structural heart conditions as well as any blockages in the coronary arteries (although the latter option would be less likely in your age group). Still, cardiac causes should still be considered in light of your elevated blood pressure as well.
These considerations can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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you said you dived into a stream,did you swallow any water??