Diarrhea From Hormone-Secreting Tumors

Introduction

Carcinoid tumors synthesize and release hormones into the blood, resulting in signs and symptoms like diarrhea and skin flushing. Carcinoid syndrome occurs when the system is flooded with serotonin hormone and other substances. Neuroendocrine tumors are formed in the specialized cells in the neuroendocrine system. This condition is usually treated through surgery and medications.

What Is Meant by Carcinoid Syndrome?

Carcinoid syndrome, or carcinoid tumor, combines systems that may indicate a neuroendocrine tumor. Neuroendocrine cells are present all over the body and produce and release hormones, whereas neuroendocrine tumors are caused by the specialized cells of the neuroendocrine system. Hormones are chemicals that help in the various functions of the body.

Neuroendocrine tumors occur when the neuroendocrine cells multiply and divide rapidly. When the neuroendocrine cells present in the gastrointestinal tract flood the system with serotonin hormone and other various substances, this results in carcinoid syndrome. Carcinoid syndrome usually occurs in people with a neuroendocrine tumor in the digestive system or lungs.

What Are the Causes of Carcinoid Syndrome?

When the gastrointestinal tract synthesis and release an excessive hormone to the liver, it results in carcinoid syndrome. When there is an increased level of hormone production, the liver manages the flow. Still, suppose the gastrointestinal tract produces excessive hormones, or the liver is affected by a neuroendocrine tumor that stops it from processing and eliminating the excess hormone. In that case, it results in a carcinoid tumor. Suppose excessive hormone flooding in every system or the liver is affected by the neuroendocrine tumor, which prevents it from eliminating the extra-produced hormone. In that case, it results in a carcinoid tumor.

What Are the Signs and Symptoms of Carcinoid Syndrome?

Carcinoid syndrome causes flushing of the head and neck and watery diarrhea, the most common signs and symptoms of carcinoid syndrome. The signs and symptoms caused by this condition usually resemble other conditions and are mistaken for menopause, Crohn's disease, or irritable bowel syndrome.

The symptoms of carcinoid tumor in the lungs:

• Chest pain.

• Wheezing.

• Shortness of breath.

• Diarrhea.

• Skin flushing, redness, and warmth in the face and neck.

• Increase in weight.

• Pink or purple marks on the face which resemble stretch marks.

The symptoms of carcinoid tumor in the digestive tract are:

• Abdominal pain.

• Diarrhea.

• Nausea and vomiting.

• Bowel obstruction where the stools cannot be passed due to intestinal blockage.

• Rectal bleeding.

• Rectal pain.

• Skin flushing.

How Is a Carcinoid Tumor or Syndrome Diagnosed?

The diagnosis of carcinoid syndrome is challenging as the signs and symptoms caused by this condition resemble the symptoms of other conditions. The doctors mainly rule out symptoms like neck flushing, diarrhea, or wheezing to diagnose carcinoid syndrome.

Various diagnostic tests are:

• Urine Test: Urine tests are performed to monitor hormonal levels.

• Physical Examination and Medical History: Most of the signs and symptoms of this condition are similar to other illnesses. The doctors question the symptoms experienced by the affected person, how long the symptoms are present, and if symptoms are worsening with time.

• Blood Test: A blood test is done to monitor the amount of substance that is produced in the blood by the organs and tissues. If there is any hike or fall in the levels of the substance, then it may be an indication of a diseased condition.

• PET (Neuroendocrine Positron Emission Tomography) Scan: With a dye called Gallium, 68 dotatate helps to track neuroendocrine tumors.

• CT (Computed Tomography) Scan: CT scan of the organs and bones shows a three-dimensional image using X-rays and a computer.

• Ultrasound: Ultrasound develops images of organs and bones using sound waves.

• Magnetic resonance imaging (MRI): MRI helps to find primary tumors, metastases, and liver metastasis.

• Endoscopy: Endoscopy is performed using a thin, flexible tube attached to a light and camera.

How Is Carcinoid Syndrome Managed?

The main symptom of neuroendocrine tumors is carcinoid syndrome, so treating neuroendocrine tumors helps to deal with this syndrome. Some standard management methods include:

• Surgery: Surgery is performed to decrease or eliminate the tumor formed.

• Somatostatin Analogs: Somatostatin analog is a form of treatment that prevents the body from producing excess hormones, which can slow down the development of tumors when there is a spread of cancerous cells all over the body.

• Targeted Therapy: In this procedure, certain specific medications target some genes and proteins to destroy cancer cells.

• Chemotherapy: This is the most common treatment followed, which destroys the cancerous cell with the help of certain drugs.

What Is the Prognosis of Carcinoid Syndrome?

If a person is diagnosed with carcinoid syndrome, there is a higher chance of a neuroendocrine tumor. This condition can be treated through surgery, targeted therapies, and chemotherapy. Most 77 percent of people treated for neuroendocrine tumors live for five years post-treatment.

How can the symptoms caused by carcinoid syndrome be managed?

The most common symptoms are flushing, wheezing, and diarrhea. These symptoms are managed by:

• Flushing: Flushing is the nervous system's reaction to any physical or emotional stress. This can be decreased through deep breaths, cooling down the face and chest using a damp cloth, or fresh air. Avoiding intake of alcohol can prevent flushing of the neck or face.

• Wheezing: Wheezing can be prevented by taking herbal tea and using a vaporizer which can enhance breathing. Smoking should be stopped, which can irritate the airways.

• Diarrhea: Diarrhea is a prevalent symptom. This can be discussed with the doctors who may provide medications to reduce the severity and frequency of diarrhea.

What Is Meant by Carcinoid Crisis?

Carcinoid crisis is a life-threatening condition that is caused due to undiagnosed or unnoticed carcinoid syndrome. This usually occurs during surgeries or trauma, like an injury from an accident. Prolonged carcinoid syndrome can cause:

• Heart failure.

• Severe diarrhea may result in an imbalance of electrolytes.

• Heart palpitations.

• Severe stomach pain.

• Blood pressure alterations.

• Sudden flushing in the neck and face.

Conclusion

Carcinoid syndrome is caused due to neuroendocrine tumor, which is caused due to excessive hormones in the blood. The main symptoms of carcinoid syndrome are wheezing, diarrhea, and flushing of the neck and face. A neuroendocrine tumor is treatable, which in turn helps to deal with carcinoid syndrome. Untreated or unnoticed carcinoid syndrome can result in a carcinoid crisis which can be life-threatening.