Specific Conditions VIPomas

Almost all patients with VIPomas have large-volume diarrhea frequently resulting in hypokalemia and dehydra-tion—hence the acronym WDHA syndrome (watery diarrhea, hypokalemia, achlorhydria), which is also used to name this syndrome in addition to Verner-Morrison syndrome. Diarrhea occurs in 100% of these patients and is due to the net secretion of fluid and electrolytes, primarily in the jejunum, caused by ectopic release of VIP by the tumor. In adults, 90% of these patients have a pancreatic endocrine tumor, which is usually malignant, whereas in children and a small percentage of adults, it is due to neural (ganglioneuroma) or adrenal tumors. These patients can have very large daily losses exceeding 400 mmol of potassium and 700 mmol of sodium and, therefore, require vigorous rehydration. Octreotide is the agent of choice to control the diarrhea in these patients.

In addition to controlling the diarrhea and rehydration, tumor localization studies using computed tomography (CT) and somatostatin receptor scintigraphy to define the location and extent of the tumor are indicated. In addition to medical treatment of the diarrhea, treatment directed against the tumor, including surgical debulking, and chemoembolization or chemotherapy for metastatic tumors are recommended.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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