American Medical Association Family Medical Guide - American Medical Association [494]
Treatment
If you have symptoms of ileus, a doctor will pass a long tube down your nose or mouth into your stomach and intestines to remove fluid and air, which relieves pain by relieving the pressure the blocked intestine is putting on adjacent tissues and organs. Further treatment of ileus depends on the cause. Because some degree of intestinal paralysis is common after abdominal surgery, doctors try to avoid or minimize the use of narcotics for pain relief because the drugs can slow the movement of the intestines.
Carcinoid Tumors
Carcinoid tumors are cancerous tumors that are most often found in the appendix but can also develop in the wall of the intestines or stomach. Although they are cancerous tumors, they develop so slowly that 50 percent of people who have them never have symptoms and the tumors are found during tests or surgery for another disorder. However, if the carcinoid tumor grows large enough, it can cause symptoms of an intestinal obstruction (see page 759). In 10 percent of cases, cells from the tumor spread through the bloodstream to the liver, where the cells multiply and form hormone-producing tumors. The hormones released by these tumors produce symptoms that are collectively called carcinoid syndrome.
Symptoms
The main symptom in carcinoid syndrome is flushing of the head and neck that lasts several hours and is usually triggered by exercise or drinking alcohol. If the cancer spreads to the liver, signs can include abdominal cramping, sudden episodes of watery diarrhea, symptoms of asthma (see page 640) such as wheezing, and symptoms of heart failure (see page 570) such as breathlessness.
Diagnosis
Carcinoid tumors can be difficult to diagnose. If you have symptoms of carcinoid syndrome, your doctor may order blood and urine tests to identify the hormone that the carcinoid tumor is secreting. He or she may also recommend a CT scan (see page 134), colonoscopy (see page 767), or endoscopy (see page 766) to examine your stomach and intestines. You may also have capsule video endoscopy (see page 767), in which you swallow a small pill containing a camera that takes a video of your small intestine.
Treatment
Surgery is the usual treatment for carcinoid tumors. However, all the tumors must be removed to eliminate the symptoms of carcinoid syndrome, which can be difficult. Your doctor may prescribe a medication called somatostatin to reduce the frequency and length of the attacks of flushing, antidiarrheals to control episodes of diarrhea, bronchodilators to relieve symptoms of asthma, and chemotherapy (see page 23) to slow the growth of the tumors.
Hernia
A hernia is a bulge of soft tissue that forces its way through or between a weak area in the muscle wall that usually contains it. Normally, body muscles are tight and firm and hold tissues and organs in position. The abdominal wall is made up of flat sheets of muscle that cover and protect the abdominal organs such as the stomach, intestines, liver, kidneys, and reproductive organs. In a hernia, muscles in the abdominal cavity that become weak and slack because of a strain, congenital (present at birth) weakness, or abdominal surgery push through a weak point in the muscle wall. A hernia usually occurs when the abdominal wall is put under pressure, such as when you cough, lift a heavy object, or strain to pass urine or have a bowel movement. An umbilical hernia (see next page) is a soft bulge of tissue around the navel of a newborn whose abdominal wall is not fully developed.
WARNING!
Strangulated Hernia
A strangulated hernia can cut off the blood supply to the intestine, causing the tissue to die, which can be life-threatening. Call 911 or your local emergency number or go to the nearest hospital emergency department immediately if you have any of the following symptoms of a strangulated hernia:
• A hernia that is very painful