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Primary hyperparathyroidism and the gastrointestinal tract

E C Gardner, T Hersh

    Southern Medical Journal
    |February 1, 1981
    PubMed
    Summary

    Gastrointestinal symptoms like nausea, vomiting, abdominal pain, and constipation are common in primary hyperparathyroidism. These symptoms often resolve after treatment for hyperparathyroidism.

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    Area of Science:

    • Endocrinology
    • Gastroenterology

    Background:

    • Primary hyperparathyroidism is a condition associated with elevated parathyroid hormone levels and hypercalcemia.
    • Gastrointestinal symptoms are frequently reported in patients with hyperparathyroidism, but their prevalence and specific manifestations require further characterization.

    Purpose of the Study:

    • To investigate the frequency of various gastrointestinal symptoms in patients diagnosed with primary hyperparathyroidism.
    • To explore the potential link between hypercalcemia and specific gastrointestinal issues such as ulcer disease and pancreatitis.

    Main Methods:

    • A retrospective analysis of 100 consecutive patients diagnosed with primary hyperparathyroidism at Emory University Hospital between January 1, 1977, and March 1, 1979.
    • Data collection focused on the presence and type of gastrointestinal symptoms at the time of diagnosis.

    Main Results:

    • At diagnosis, a significant proportion of patients experienced gastrointestinal symptoms: 28% reported nausea, 19% vomiting, 29% abdominal pain, and 33% constipation.
    • Among the patients studied, 14 had a history of ulcer disease (including gastric and duodenal ulcers), and one patient presented with acute pancreatitis.
    • Hypercalcemia, a hallmark of primary hyperparathyroidism, is implicated in increased gastric acid secretion, potentially explaining ulcer disease and related pain.

    Conclusions:

    • Gastrointestinal symptoms are prevalent in primary hyperparathyroidism and can significantly impact patient well-being.
    • Hypercalcemia may contribute to ulcer disease and ulcer-like abdominal pain, though mechanisms for other symptoms require further investigation.
    • The resolution of these gastrointestinal symptoms following treatment for primary hyperparathyroidism underscores the importance of managing the underlying endocrine disorder.

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