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Gastroenterology (Expert Forum)
Carcinoid?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Carcinoid?
by Nanlyn, Jun 13, 2005 12:00AM
I have not been diagnosed yet but my story starts in Jan of 2005 when I started getting flushing. Since I am 45, I assumed at first that it was hot flashes. It happened once or twice a month and seemed to be worse each time. The last time it happened on May 11, I was right near my dermatologists office so I went in for him to have a look. He thought it too severe of a flush to be hot flashes and sent me for a urine test for Carcinoid Syndrome. That test came back normal. I then went to my endocrinologist (have a thyroid condition). He took blood test which was normal for estrogen and thyroid. He sent me for a histamine urine test which has come back high. He is also sending me for a repeat of the carcinoid urine test. I have not spoken to him yet about the high histamine (learned my results from a friend in the lab!). Needless to say, I am freaking out now because I have read that high histamine is also a carcinoid symptom. I do not have any other symptoms related to carcinoid except for the flushing. I should tell you that my mom had pancreatic cancer if it helps. I was also told I should probably go for an abdominal CT scan. What would you suggest? And how do you see this? Thanks
Doctor's Answer
by Kevin Pho, MD, Jun 14, 2005 12:00AM
, Jun 14, 2005 12:00AM
The urinary test for the 5-HIAA metabolite is normally the initial screen for carcinoid syndrome. The test has been shown to have a sensitivity around 75% - meaning that it will miss 25% of cases.
Another option would be a blood serotonin concentration which is a more sensitive test.
If either of these tests are elevated, you can consider imaging studies. Two tests are normally used in conjunction with each other - abdominal CT and the indium-111 octreotide imaging.
You can discuss these options with your personal physician, or in conjunction with a GI 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
Another option would be a blood serotonin concentration which is a more sensitive test.
If either of these tests are elevated, you can consider imaging studies. Two tests are normally used in conjunction with each other - abdominal CT and the indium-111 octreotide imaging.
You can discuss these options with your personal physician, or in conjunction with a GI 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
