Digestive Disorders / Gastroenterology Expert Forum
Diarrhea and hives
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Diarrhea and hives

One year ago my husband (age 54) began having these "attacks". He becomes nauseous, developes hives all over his body and then gets violent diarrhea. He turns white and then gets the cold sweats. When the attack is over he is just exhausted. These attacks last for 1 1/2 hours.  We had him tested for allergies......none.  They tested his liver...perfect.  After one attack on Christmas Day he had a heart attack...the doctors said no relation between the two.  They call them "histamine attacks"  

We have tied them to meals with higher fat content or rich foods....Thanksgiving, Christmas, vactions, etc....times when we are apt to not watch what we eat.

I think they are connected to the removal of his gall bladder (20+ years ago) but nowhere can I find hives metioned along with the other symptoms.

Any help would appreciated.
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Hello - thanks for asking your question.

There are several conditions that can cause this "histamine" reaction that is described.  This would include the carcinoid syndrome, systemic mastocytosis, or a tumor known as a VIPoma for instance.

High blood pressure, flushing, abdominal cramps, diarrhea and, more rarely, valvular heart disease are all suggestive of carcinoid syndrome.  Histamine is one of the substances that are released by carcinoid tumors.  

The most common test for carcinoid tumors is a 24-hour urinary excretion of 5-hydroxyindoleacetic acid (HIAA).  Blood tests for HIAA can also be obtained.  Tests to provoke the flushing (either with epinephrine or pentagastric) can also be considered to test for the carcinoid syndrome.  

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.

Thanks,
Kevin, M.D.
1 Comment
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Not likely related to the gallbladder surgery, but suspicious for a histamine-producing tumor. Collecting 24 hours of urine and testing it for certain chemicals is one way to find out. There's something called "carcinoid syndrome." Be sure his doctors have considered it.
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