THE SYMPTOMS OF CARCINOID SYNDROME
Over 90% of people with carcinoid syndrome experience flushing. Flushing resembles an intense blush, a deep red or purple hue that appears suddenly on the face or neck—although the flush may appear on the upper back or legs as well. The flush can be triggered by emotions, by eating, or by drinking alcohol or hot liquids. When it occurs, you may feel warm or unpleasant sensations in the affected areas, and be aware of having a rapid heartbeat. The flush is caused by dilation of the blood vessels in the affected area of skin. It can last from a few minutes to hours, and in some cases may even be constant. The stage of carcinoid syndrome you are in can determine how long flushing lasts. In more severe cases, facial skin sometimes thickens and discolors. Flushing in carcinoid syndrome is more likely to be “dry” flushing (flushing that is not accompanied by sweating) rather than “wet” flushing (flushing that is accompanied by sweating).
HEART VALVULAR LESIONS
One of the more serious symptoms of carcinoid syndrome is heart valvule lesions, a condition in which excess serotonin causes injury to the valves of the heart. This leads to a unique set of problems with the way your heart functions, called carcinoid heart disease. Cardiac disease develops in 11% to 66% of carcinoid patients.
Peripheral oedema, a swelling of the ankles, legs, hands and arms, or neck and face, may also occur in people with carcinoid syndrome. This symptom may be a sign of heart problems, and you should see your doctor if you notice it.
Pellagra is a rare nutritional deficiency that causes symptoms such as skin rash because of the lack of niacin.
About 78% of people with carcinoid syndrome experience diarrhoea, which can occur with flushing or by itself. Stools are watery and the diarrhoea can be mild or severe. Episodes can occur several times a day and can interfere with daily life. Patients with severe cases of diarrhoea often have trouble leaving their homes for work, social functions, or activities that require being away from home and on the move for a long time. In addition, diarrhoea can drain your body of water, causing dehydration and electrolyte loss. Without enough water and electrolytes, proper digestion cannot occur, and your body cannot get the nutrients it needs. This can worsen the weight loss, weakness, and fatigue that may have already have been caused by the loss of fluids and electrolytes. The diarrhoea that results from carcinoid syndrome may also occur at night (nocturnal diarrhoea).
People with carcinoid syndrome sometimes develop telangiectasia -reddish spots or veins that appear most often on the face, chest or arms. These are caused by prolonged flushing.
Exposure of lung tissues to abnormally high levels of certain substances can cause the blood vessels to constrict, and narrow the airway passages, making it difficult to breathe. This wheezing can be mistaken for asthma.
Cyanosis refers to characteristic bluish skin spots that can develop in people with carcinoid syndrome. The spots may appear after flushing, and are produced by a lack of oxygenated blood circulation in the affected areas.