Differentials
Irritable bowel syndrome
SIGNS / SYMPTOMS
Often presents with intermittent and chronic history of diarrhoea.
INVESTIGATIONS
Urinary 5-hydroxyindoleacetic acid (5-HIAA) and chromogranin A will be normal.
Crohn's disease
SIGNS / SYMPTOMS
Right lower quadrant pain and peri-anal lesions. May also present with oral lesions.
INVESTIGATIONS
Urinary 5-HIAA and chromogranin A will be normal.
Inflammatory markers such as C-reactive protein may be elevated in Crohn's disease.
Evidence of Crohn's disease on endoscopy.
Menopause
SIGNS / SYMPTOMS
Amenorrhoea or irregular menstrual cycle; vaginal dryness, itching, and dyspareunia; pale, dry vaginal mucosa with decreased rugosity; mood changes.
INVESTIGATIONS
Urinary 5-HIAA and chromogranin A will be normal. Gonadotrophins (LH/FSH) will be elevated.
Asthma
SIGNS / SYMPTOMS
If wheeze is the only symptom of myxoma carcinoid, then it may be mistaken for asthma. Absence of diarrhoea and abdominal pain.
INVESTIGATIONS
Urinary 5-HIAA and chromogranin A will be normal.
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