{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:29:34Z","timestamp":1787164174283,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pheochromocytomas (PHs) and sympathetic paragangliomas (PGs) are tumors that produce catecholamines, predisposing patients to cardiovascular disease and gastrointestinal effects such as constipation. Objectives: i) determine the prevalence of constipation, its risk factors, and its impact on survival; ii) identify whether a systematic combination of fiber, water, and laxatives was effective for treatment of constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>We retrospectively studied 396 patients with PH\/PG diagnosed in 2005\u20132014. The study population was patients with constipation as a presenting symptom; the control group was patients without constipation as a presenting symptom. The MD Anderson Symptom Inventory was used to assess constipation and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-three patients (6%) had constipation. Constipation was associated with headaches, palpitations, diaphoresis, weight loss, and excessive noradrenaline production (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Eighteen of these patients had non-metastatic primary tumors larger than 5\u200acm and\/or extensive metastases. No statistically significant differences in age, sex, and genotype were noted between the study and control groups. In patients without metastases, resection of the primary tumor led to symptom disappearance. A systematic combination of fiber, water, and laxatives was associated with symptom improvement. Two patients who presented unmanaged constipation died because of sepsis from toxic megacolon.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Constipation is a rare and potentially lethal complication in patients with PH\/PGs. Severe constipation can be prevented by recognizing and treating mild symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/eje-15-0456","type":"journal-article","created":{"date-parts":[[2015,6,9]],"date-time":"2015-06-09T22:56:39Z","timestamp":1433890599000},"page":"377-387","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":58,"title":["Constipation: an overlooked, unmanaged symptom of patients with pheochromocytoma and sympathetic paraganglioma"],"prefix":"10.1093","volume":"173","author":[{"given":"Sonali","family":"Thosani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Ayala-Ramirez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Rom\u00e1n-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouhao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav","family":"Thosani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Bisanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2015080418004305000_173.3.377.1","unstructured":"Osinga TE Kerstens MN van der Klauw MM Koornstra JJ Wolffenbuttel BH Links TP van der Horst-Schrivers AN . Intestinal pseudo-obstruction as a complication of paragangliomas: case report and literature review. Netherlands Journal of Medicine 2013 71 512\u2013517."},{"key":"2015080418004305000_173.3.377.2","doi-asserted-by":"crossref","unstructured":"Huang WS Wang CS Hsieh CC Lin PY Chin CC Wang JY . Management of patients with stercoral perforation of the sigmoid colon: report of five cases. World Journal of Gastroenterology 2006 12 500\u2013503.","DOI":"10.3748\/wjg.v12.i3.500"},{"key":"2015080418004305000_173.3.377.3","doi-asserted-by":"crossref","unstructured":"Karri V Khan SL Wilson Y . Bowel perforation as a presenting feature of pheochromocytoma: case report and literature review. Endocrine Practice 2005 11 385\u2013388. (doi:10.4158\/EP.11.6.385).","DOI":"10.4158\/EP.11.6.385"},{"key":"2015080418004305000_173.3.377.4","doi-asserted-by":"publisher","DOI":"10.1177\/014107688407700414"},{"key":"2015080418004305000_173.3.377.5","doi-asserted-by":"crossref","unstructured":"Hashimoto Y Motoyoshi S Maruyama H Sakakida M Yano T Yamaguchi K Goto K Sugihara S Takano S Kambara T . The treatment of pheochromocytoma associated with pseudo-obstruction and perforation of the colon, hepatic failure, and DIC. Japanese Journal of Medicine 1990 29 341\u2013346. (doi:10.2169\/internalmedicine1962.29.341).","DOI":"10.2169\/internalmedicine1962.29.341"},{"key":"2015080418004305000_173.3.377.6","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.029"},{"key":"2015080418004305000_173.3.377.7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20001001)89:7<1634::AID-CNCR29>3.0.CO;2-V"},{"key":"2015080418004305000_173.3.377.8","doi-asserted-by":"crossref","unstructured":"Talley NJ Lasch KL Baum CL . A gap in our understanding: chronic constipation and its comorbid conditions. Clinical Gastroenterology and Hepatology 2009 7 9\u201319. (doi:10.1016\/j.cgh.2008.07.005).","DOI":"10.1016\/j.cgh.2008.07.005"},{"key":"2015080418004305000_173.3.377.9","doi-asserted-by":"crossref","unstructured":"Avila JG . Pharmacologic treatment of constipation in cancer patients. Cancer Control 2004 11 10\u201318.","DOI":"10.1177\/10732748040110S303"},{"key":"2015080418004305000_173.3.377.10","doi-asserted-by":"publisher","DOI":"10.1188\/08.CJON.317-337"},{"key":"2015080418004305000_173.3.377.11","unstructured":"Bisanz A . Managing bowel elimination problems in patients with cancer. Oncology Nursing Forum 1997 24 679\u2013686; quiz 687-678."},{"key":"2015080418004305000_173.3.377.12","doi-asserted-by":"crossref","unstructured":"Twycross R Sykes N Mihalyo M Wilcock A . Stimulant laxatives and opioid-induced constipation. Journal of Pain and Symptom Management 2012 43 306\u2013313. (doi:10.1016\/j.jpainsymman.2011.12.002).","DOI":"10.1016\/j.jpainsymman.2011.12.002"},{"key":"2015080418004305000_173.3.377.13","doi-asserted-by":"publisher","DOI":"10.1038\/nature13430"},{"key":"2015080418004305000_173.3.377.14","doi-asserted-by":"publisher","DOI":"10.1038\/415206a"},{"key":"2015080418004305000_173.3.377.15","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536062"},{"key":"2015080418004305000_173.3.377.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604253341707"},{"key":"2015080418004305000_173.3.377.17","doi-asserted-by":"crossref","unstructured":"Liddle R. Gastrointestinal hormones and neurotransmitters. In Sleisenger and Fordtran's Gastrointestinal and Liver Disease Pathophisiology, Diagnosis, Management. pp 3\u201325. Eds M Feldman & L Friedman, L Brandt: Saunders Elsevier, 2010","DOI":"10.1016\/B978-1-4160-6189-2.00001-9"},{"key":"2015080418004305000_173.3.377.18","doi-asserted-by":"crossref","unstructured":"Szakacs JE Cannon A . L-Norepinephrine myocarditis. American Journal of Clinical Pathology 1958 30 425\u2013434.","DOI":"10.1093\/ajcp\/30.5.425"},{"key":"2015080418004305000_173.3.377.19","doi-asserted-by":"crossref","unstructured":"Hussain ZH Whitehead DA Lacy BE . Fecal impaction. Current Gastroenterology Reports 2014 16 404. (doi:10.1007\/s11894-014-0404-2).","DOI":"10.1007\/s11894-014-0404-2"},{"key":"2015080418004305000_173.3.377.20","doi-asserted-by":"crossref","unstructured":"Saksonov M Bachar GN Morgenstern S Zeina AR Vasserman M Protnoy O Benjaminov O . Stercoral colitis: a lethal disease-computed tomographic findings and clinical characteristic. Journal of Computer Assisted Tomography 2014 38 721\u2013726. (doi:10.1097\/RCT.0000000000000117).","DOI":"10.1097\/RCT.0000000000000117"},{"key":"2015080418004305000_173.3.377.21","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197711)40:5<1987::AID-CNCR2820400502>3.0.CO;2-R"},{"key":"2015080418004305000_173.3.377.22","doi-asserted-by":"crossref","unstructured":"Mullen JP Cartwright RC Tisherman SE Misage JR Shapiro AP . Pathogenesis and pharmacologic management of pseudo-obstruction of the bowel in pheochromocytoma. American Journal of the Medical Sciences 1985 290 155\u2013158. (doi:10.1097\/00000441-198510000-00004).","DOI":"10.1097\/00000441-198510000-00004"},{"key":"2015080418004305000_173.3.377.23","doi-asserted-by":"crossref","unstructured":"Engelman K Horwitz D J\u00e9quier E Sjoerdsma A . Biochemical and pharmacologic effects of \u03b1-methyltyrosine in man. Journal of Clinical Investigation 1968 47 577\u2013594. (doi:10.1172\/JCI105754).","DOI":"10.1172\/JCI105754"},{"key":"2015080418004305000_173.3.377.24","unstructured":"Robertson D & Biaggioni I. Adrenoreceptor antagonist drugs. In Basic and Clinical Pharmacology. pp 151\u2013168. Eds B Katzung & A Trevor. USA: McGraw-Hill Education, 2014"},{"key":"2015080418004305000_173.3.377.25","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-013-0320-x"},{"key":"2015080418004305000_173.3.377.26","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0113"},{"key":"2015080418004305000_173.3.377.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707377"},{"key":"2015080418004305000_173.3.377.28","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2009.0054"},{"key":"2015080418004305000_173.3.377.29","doi-asserted-by":"crossref","unstructured":"Kim YW Kwon HJ Kim IY . Stercoral perforation of the colon in sigmoid colostomy patients: two case reports. International Journal of Surgery Case Reports 2013 4 1038\u20131040. (doi:10.1016\/j.ijscr.2013.09.005).","DOI":"10.1016\/j.ijscr.2013.09.005"},{"key":"2015080418004305000_173.3.377.30","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6480"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/173\/3\/377.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/173\/3\/377.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T11:32:53Z","timestamp":1676374373000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/173\/3\/377\/6668009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":30,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/eje-15-0456","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}