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Family Medicine (Expert Forum)
Carcinoid Syndrome - possibility or something else.
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Carcinoid Syndrome - possibility or something else.
by ADS1958, May 02, 2006 12:00AM
Right at the moment I'm a bit scared, actually quite a bit scared.
For about a month, maybe longer, I have had ever increasing episodes of facial flushing. It started at first only at the ears and nose and has gotten to a point where it now involves my cheeks, forehead and temples. There is no involvement of the torso at all. The flushing is not a deep red most of the time but it feels like an intense sunburn. Additionally the skin on the back of my hands from knuckle to knuckle is now turning dry and red. The flushing is aggravated by the sun and by dry heat. It seems to come on in stressful situations most often and when eating spicy foods. I have always been prone to blushing rather easily and my ears have always turned bright red by having them touched
Additionally I have been battling diarrhea for the past few weeks. This is not unusual for me as I have been diagnosed as gluten sensitive and had gone off my gluten-free diet prior to the diarrhea starting up. I battled diarrhea for months and months prior to the gluten sensitive diagnosis. The diarrhea is eased quite a bit by taking pepto bismol. I am taking about eight tablets a day which worked in easing the diarrhea the last time around. There was no facial flushing then. The diarrhea has many peices of undigested food in it.
After scaring myself half to death by searching my symptoms on the Internet I saw my GP today. His first thought was that i might have a rotavirus, a helicobacter problem or a parasite. He then recalled my gluten problem and thought maybe my going off the gluten-free diet had triggered the problems.
I then brought up carcinoid syndrome since he didn't and his initial reaction was that he doubted it since the flushing was accompanied by the sunburn feeling and that the flush persisted for so long. He ordered up numerous tests, blood work, urine work and a stool samples. He included the 5-HIAA test in order to rule out carcinoid.
Anyway I'm still quite a bit scared of what the results will be. I've beaten a brain tumor (tumor free for the past 6 years thanks to radiation therapy) and don't want to face another threat.
Thanks for any comments you may have.
Sincerely,
Alan Shepard
For about a month, maybe longer, I have had ever increasing episodes of facial flushing. It started at first only at the ears and nose and has gotten to a point where it now involves my cheeks, forehead and temples. There is no involvement of the torso at all. The flushing is not a deep red most of the time but it feels like an intense sunburn. Additionally the skin on the back of my hands from knuckle to knuckle is now turning dry and red. The flushing is aggravated by the sun and by dry heat. It seems to come on in stressful situations most often and when eating spicy foods. I have always been prone to blushing rather easily and my ears have always turned bright red by having them touched
Additionally I have been battling diarrhea for the past few weeks. This is not unusual for me as I have been diagnosed as gluten sensitive and had gone off my gluten-free diet prior to the diarrhea starting up. I battled diarrhea for months and months prior to the gluten sensitive diagnosis. The diarrhea is eased quite a bit by taking pepto bismol. I am taking about eight tablets a day which worked in easing the diarrhea the last time around. There was no facial flushing then. The diarrhea has many peices of undigested food in it.
After scaring myself half to death by searching my symptoms on the Internet I saw my GP today. His first thought was that i might have a rotavirus, a helicobacter problem or a parasite. He then recalled my gluten problem and thought maybe my going off the gluten-free diet had triggered the problems.
I then brought up carcinoid syndrome since he didn't and his initial reaction was that he doubted it since the flushing was accompanied by the sunburn feeling and that the flush persisted for so long. He ordered up numerous tests, blood work, urine work and a stool samples. He included the 5-HIAA test in order to rule out carcinoid.
Anyway I'm still quite a bit scared of what the results will be. I've beaten a brain tumor (tumor free for the past 6 years thanks to radiation therapy) and don't want to face another threat.
Thanks for any comments you may have.
Sincerely,
Alan Shepard
Doctor's Answer
by Kevin Pho, MD, May 03, 2006 12:00AM
, May 03, 2006 12:00AM
Difficult to say without evaluation.
Carcinoid was what I thought of as well. The 5-HIAA urine test is the appropriate test to screen for this disease.
Diarrhea with undigested food can be indicative of a malabsorption syndrome - this can be evaluated with fecal fat tests as well as a lower endoscopy (i.e. either colonoscopy or flexible sigmoidoscopy).
If the GI tests remain non-revealing, you can consider looking a rheumatological disease - which can lead to facial flushing and rash. An ANA test as well as rheumatoid factor can be considered as an initial screen.
These options 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.
kevinmd_
Carcinoid was what I thought of as well. The 5-HIAA urine test is the appropriate test to screen for this disease.
Diarrhea with undigested food can be indicative of a malabsorption syndrome - this can be evaluated with fecal fat tests as well as a lower endoscopy (i.e. either colonoscopy or flexible sigmoidoscopy).
If the GI tests remain non-revealing, you can consider looking a rheumatological disease - which can lead to facial flushing and rash. An ANA test as well as rheumatoid factor can be considered as an initial screen.
These options 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.
kevinmd_
