Gastrointestinal symptoms in acromegaly: A case control study

Inayet, Nashiz; Hayat, Jamal; Bano, Gul; Poullis, Andrew

doi:10.4292/wjgpt.v11.i2.17

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Another problem that can compromise the success of the exam is the difficulty in preparing the patient, since intestinal transit in acromegaly is slower than normal subjects. This can be explained by autonomic intestinal impairment due to vagal hypertonia, a hormonal imbalance influenced by the interactions between GH and ghrelin and the action of the increased IGF-I levels, which may stimulate the proliferation of intestinal epithelial cells ( 69 ). Gut motility disturbance can also occur in treated patients with somatostatin receptor ligands ( 69 ).…”

Section: Limitations Of Epidemiological Studies and Of Colonoscopy In...mentioning

confidence: 99%

“…This can be explained by autonomic intestinal impairment due to vagal hypertonia, a hormonal imbalance influenced by the interactions between GH and ghrelin and the action of the increased IGF-I levels, which may stimulate the proliferation of intestinal epithelial cells ( 69 ). Gut motility disturbance can also occur in treated patients with somatostatin receptor ligands ( 69 ). Therefore, standard bowel preparations could lead to suboptimal results ( 70 ).…”

Section: Limitations Of Epidemiological Studies and Of Colonoscopy In...mentioning

confidence: 99%

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Acromegaly and Colorectal Neoplasm: An Update

2022

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Acromegaly is a systemic disease caused by excessive inappropriate secretion of GH and IGF-I levels, resulting in many systemic complications, including cardiovascular, respiratory, metabolic diseases, and a possible increased risk of some neoplasias. Although many studies on acromegaly and cancer remain uncertain, most data indicate that colorectal cancer (CRC) incidence is increased in this population. The exact mechanism involved in the role of GH-IGF-I axis in CRC has not been fully explained, yet it is associated with local and circulating effects of GH and IGF-I on the colon, promoting angiogenesis, cell proliferation, risk of mutation, inhibition of tumor-suppressor genes and apoptosis, thus facilitating a tumor microenvironment. Nevertheless, population-based studies present controversial findings on CRC incidence and mortality. All worldwide guidelines and expert consensuses agree with the need for colonoscopic screening and surveillance in acromegaly, although there is no consensus regarding the best period to do this. This review aims to analyze the existing data on CRC and acromegaly, exploring its pathophysiology, epidemiological studies and their limitations, colonic polyp characteristics, overall cancer and CRC incidences and mortality, risk factors for colon cancer pathophysiology, and recommendation guideline aspects.

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Section: Limitations Of Epidemiological Studies and Of Colonoscopy In...mentioning

confidence: 99%

Section: Limitations Of Epidemiological Studies and Of Colonoscopy In...mentioning

confidence: 99%

Acromegaly and Colorectal Neoplasm: An Update

2022

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“…A study done in 2020 by Inayet et al suggested that the most cited issue in patients with acromegaly is functional constipation. Such abdominal symptoms in patients with acromegaly may serve as a red flag for the physician, prompting him or her to suspect and begin screening [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

Acromegaly and the Colon: Scoping Beyond the Pituitary

Patel¹,

Grossmann²,

Rodriguez³

et al. 2021

Cureus

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Acromegaly is a complex endocrinological disorder commonly caused by hypersecretion of growth hormone (GH) typically due to pituitary gland tumors. Patients with acromegaly who are successfully treated and biochemically managed have a reasonably average life expectancy. However, it causes a cascade of multisystemic involvement throughout the patient's life, including cardiovascular, neuropsychiatric, respiratory, metabolic, neurological, neoplastic, and gastrointestinal involvement, resulting in a higher rate of hospitalization, lower quality of life, and a shorter life expectancy. Although cardiovascular complications are the primary cause of death in patients with acromegaly, malignancy is now emerging as a major killer in these individuals. Colorectal carcinoma has been reported to be prevalent in acromegaly individuals. This review article has compiled studies to demonstrate a link between acromegaly and colorectal neoplasia, intending to provide a strong foundation for their clinical relationship. This article has summarised a potential pathogenic mechanism and provided insights into the clinical presentation of such patients. Furthermore, this article has provided a brief overview of current screening recommendations for colorectal neoplasia in acromegaly patients.

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