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Rectal Mechano-sensory Function in Patients with Carcinoid Diarrhea
Tine Gregersen1, Christina Brock2, Anne-Mette Haase1
1Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Journal of Neurogastroenterology and Motility
|December 23, 2015
Summary
Patients with carcinoid diarrhea exhibit reduced rectal sensitivity to heat but normal response to mechanical stimuli. Treatment should focus on gut transit and secretion, not rectal sensory function.
Area of Science:
- Gastroenterology
- Neuroendocrinology
- Physiology
Background:
- Carcinoid syndrome, resulting from excess serotonin in neuroendocrine tumors, causes diarrhea and flushing.
- The pathophysiology of carcinoid diarrhea is poorly understood.
- Rectal hypersensitivity and increased tone are linked to diarrhea in other patient groups.
Purpose of the Study:
- To compare rectal sensitivity and compliance in patients with carcinoid diarrhea versus healthy individuals.
- To investigate the role of rectal mechano-sensory properties in carcinoid diarrhea.
Main Methods:
- Included 12 patients with carcinoid diarrhea and 19 healthy controls.
- Assessed rectal mechano-sensory properties using mechanical and heat stimulation.
Main Results:
- Patients with carcinoid diarrhea required higher temperatures (48.1°C vs 44.7°C) for sensory response, indicating reduced heat sensitivity (P=0.041).
- No significant differences were found in rectal sensory response to mechanical distension (P=0.731) or rectal compliance (P=0.990).
Conclusions:
- Carcinoid diarrhea is associated with elevated heat sensory thresholds but normal mechanical sensitivity and rectal compliance.
- Therapeutic strategies for carcinoid diarrhea should prioritize modulating gastrointestinal transit and reducing secretion over altering rectal mechano-sensory function.
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