title: Colorectal manifestations of endocrine disease.
abstract: OBJECTIVE
  The aim of this review is to alert the colon and rectal surgeon to the colorectal manifestations of endocrine disease.
  
  
  METHODS
  This report was obtained by a review of the medical literature. Endocrine disease may initially present as a symptom felt to be referable to colorectal disease. Furthermore symptoms of well-established endocrine disorders may have refractory colorectal symptoms.
  
  
  RESULTS
  Constipation is the most common gastrointestinal symptom of diabetics; however, in patients with brittle diabetes, diarrhea may be chronic and intermittent. Unexplained diarrhea, despite an exhaustive work-up for an etiology, should alert the clinician to the possibility of a pancreatic endocrine tumor. Thyroid disorders, depending on activity of the gland, may have refractory constipation, diarrhea, or steatorrhea as the only presenting symptoms. Constipation is a common symptom of hypercalcemia, secondary to hyperparathyroidism. Primary hyperparathyroidism has been associated with increased incidence of malignancies, specifically of colonic origin. In patients with acromegaly a threefold to eightfold increased risk of colon carcinoma or adenomatous polyps is seen. Chronic adrenal insufficiency may present initially as diarrhea and malabsorption. The adrenal gland is a frequent site of metastases from colorectal cancer. Pheochromocytomas may be a cause of occult gastrointestinal bleeding or ischemic colitis.
  
  
  CONCLUSIONS
  Unexplained symptoms referable to the colon and rectum should alert the clinician to the possibility of an underlying endocrine disorder.
authors.affiliation: Department of Surgery, St. Louis University School of Medicine, Missouri 63110-0250.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: W E
authors.initials: WE
authors.lastname: Longo
authors.forename: B
authors.initials: B
authors.lastname: Baniadam
authors.forename: A M
authors.initials: AM
authors.lastname: Vernava
mesh_terms: D003108:Colonic Diseases / Q000150:complications*; D004700:Endocrine System Diseases / Q000150:complications*; D006801:Humans; D012002:Rectal Diseases / Q000150:complications*