{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:11:23Z","timestamp":1784232683069,"version":"3.55.0"},"reference-count":63,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Managing gastrointestinal symptoms in patients with phaeochromocytoma and paraganglioma (PPGL) is challenging due to the risk of catecholaminergic crisis with many commonly prescribed medications, especially in functional tumours. We reviewed gastrointestinal symptom management and outcomes in PPGL patients at our centre and developed recommendations based on a literature review and our experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Patients, Measurement<\/jats:title><jats:p>A single\u2010centre retrospective analysis of the management of gastrointestinal symptoms in patients with PPGL between 2019 and 2024 was completed. A literature review of gastrointestinal manifestations in PPGL was undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010four individuals with PPGL admitted for radionuclide therapy, chemotherapy, surgery or other medical illness were included. Eighteen (75%) had metastatic disease. Fifty administration events of antiemetics for nausea or vomiting occurred. Two patients had acute colonic pseudo\u2010obstruction. Dopamine antagonists (metoclopramide) and corticosteroids (dexamethasone) were administered to 10 and 9 patients, respectively, the majority of whom were alpha\u2010blocked (<jats:italic>n<\/jats:italic>\u2009=\u20097) or had a dopaminergic\/biochemically silent phenotype (<jats:italic>n<\/jats:italic>\u2009=\u200910). A patient with noradrenergic PPGL experienced a hypertensive episode following high\u2010dose dexamethasone. No patients with biochemically negative\/dopaminergic phenotypes or on alpha blockade experienced an antiemetic\u2010related adverse event. Published evidence of dopamine antagonists and corticosteroids precipitating catecholaminergic crisis was mostly limited to case reports. While low\u2010risk antiemetics (serotonin, histamine or neurokinin antagonists) are preferable, we found higher\u2010risk antiemetics (dexamethasone and metoclopramide) can be cautiously administered in patients with a biochemically negative\/dopaminergic phenotype or in those on adequate alpha blockade. Limited case reports demonstrated anti\u2010cholinergic agents were beneficial for the management of <jats:italic>acute<\/jats:italic> colonic pseudo\u2010obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Optimal management of gastrointestinal symptoms in PPGL should consider disease characteristics such as primary location, secretory profile, alpha blockade and medication profile.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15235","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T17:05:47Z","timestamp":1742835947000},"page":"21-35","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Approach to the Management of Gastrointestinal Manifestations in Patients With Phaeochromocytoma and Paraganglioma"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9796-4687","authenticated-orcid":false,"given":"Monica","family":"Majumder","sequence":"first","affiliation":[{"name":"Endocrinology and Diabetes Department St Vincent's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherie","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Melbourne Fitzroy Victoria Australia"},{"name":"Department of Internal Medicine Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Molecular Imaging and Therapeutic Nuclear Medicine Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Michael","sequence":"additional","affiliation":[{"name":"Department of Molecular Imaging and Therapeutic Nuclear Medicine Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirupa","family":"Sachithanandan","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Department St Vincent's Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine The University of Melbourne Fitzroy Victoria Australia"},{"name":"Department of Internal Medicine Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Boehm","sequence":"additional","affiliation":[{"name":"Department of Molecular Imaging and Therapeutic Nuclear Medicine Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Department of Clinical Pathology, Centre for Cancer Research University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnab019"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14030594"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-2025"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1530\/EO-22-0080"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-15-0268"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-010-9319-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-022-01868-6"},{"issue":"1","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40981-019-0255-9","article-title":"Perioperative Anesthetic Management of Intestinal Pseudo\u2010Obstruction as a Complication of Pheochromocytoma","volume":"5","author":"Okumura S.","year":"2019","journal-title":"JA Clinical Reports"},{"issue":"10","key":"e_1_2_10_10_1","first-page":"512","article-title":"Intestinal Pseudo\u2010Obstruction as a Complication of Paragangliomas: Case Report and Literature Review","volume":"71","author":"Osinga T. 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