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Zollinger–Ellison syndrome (Z-E syndrome) is a rare disease in which tumors cause the stomach to produce too much acid, resulting in peptic ulcers. Symptoms include abdominal pain and diarrhea. The syndrome is caused by the formation of a gastrinoma, a neuroendocrine tumor that secretes a hormone called gastrin. [2]
Gastrinoma in the early stages will have signs and symptoms of indigestion [3] or similar to irritable bowel disease (IBD) such as: Hypergastrinemia [3] Refractory or recurrent peptic ulcers involving duodenum [3] Chronic diarrhea [7] [2] [3] Generalized cancer symptoms; Abdominal pain [3] Gastrointestinal bleeding [3] Obstruction of intestine [8]
Causes of gastric outlet obstruction include both benign causes, such as peptic ulcer disease affecting the area around the pylorus, and malignant causes, such as gastric cancer. Causation related to ulcers may involve severe pain which the patient may interpret as a heart condition or attack.
Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer , while one in the first part of the intestines is a duodenal ulcer . [ 1 ]
A persistent (chronic) history of diarrhea, with watery or mushy, unformed stools, (types 6 and 7 on the Bristol stool scale), sometimes with steatorrhea, increased frequency and urgency of defecation are common manifestations, often with fecal incontinence and other gastrointestinal symptoms such as abdominal swelling, bloating and abdominal pain.
Lab work: Lab work must be done to diagnose milk-alkali syndrome. Lab workup includes serum calcium levels, parathyroid hormone (PTH), phosphorus, creatinine, blood urea nitrogen (BUN), magnesium, and vitamin D levels. Primary hyperparathyroidism has to be excluded. [12] Diagnosis is made by looking at past medical history and laboratory studies.
The prodromal symptoms are fever, headache, and myalgia, which can be severe, lasting as long as 24 hours. After 1–5 days, typically, these are followed by diarrhea (as many as 10 watery, frequently bloody, bowel movements per day) or dysentery, cramps, abdominal pain, and fever as high as 40 °C (104 °F). In most people, the illness lasts ...
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).