Hyperparathyroidism is a challenging disease to diagnose due to its vague symptoms. Doctors often look at bone and joint pain and cognitive issues when considering hyperparathyroidism. However, many patients also experience gastrointestinal symptoms. If hyperparathyroidism is the cause, surgical treatment often improves or reverses the digestive problems and other symptoms.
Common Gastrointestinal Symptoms in Hyperparathyroidism Patients
More than half of hyperparathyroidism patients experience gastrointestinal symptoms like constipation, bloating, and abdominal pain. Fewer people experience nausea and vomiting. One study also linked heartburn and appetite loss to hyperparathyroidism.
The link between hyperparathyroidism and gastrointestinal disorders should prompt physicians to consider hyperparathyroidism, especially when other symptoms are present, such as:
- Persistent fatigue
- Difficulty focusing or concentrating
- Memory loss
- Bone and joint pain
- Muscle weakness
- Frequent urination
- Depression or anxiety
- Hair loss
Occasionally, hyperparathyroidism can lead to acute pancreatitis, which occurs when the pancreas becomes inflamed. Pancreatitis symptoms include:
- Abdominal pain or tenderness
- Belly pain that radiates to the back
- Fever
- Nausea and vomiting
- Quickened pulse
Acute pancreatitis is a leading cause of hospitalization among patients with gastrointestinal disorders in the U.S. Although it is a rare symptom of hyperparathyroidism, experts recommend testing for the disease when pancreatitis is present without another known cause.
The Link Between Hyperparathyroidism and Gastrointestinal Diseases
The culprit behind hyperparathyroidism and digestive disorders is likely the elevated calcium levels commonly seen with this disease. Four tiny parathyroid glands regulate calcium levels in the bloodstream, adjusting as needed to keep calcium stable. When calcium levels drop, the parathyroid glands produce parathyroid hormone (PTH) to bring calcium back up.
Primary hyperparathyroidism occurs when a benign tumor called an adenoma forms on one of the glands, interfering with the calcium sensor and causing the gland to produce PTH continuously. Elevated PTH raises calcium levels in the blood, which affects many body functions, including the digestive system.
Secondary hyperparathyroidism also leads to abnormal calcium levels, causing the parathyroid gland to malfunction. An underlying medical issue, such as vitamin D deficiency or kidney disease, causes this condition. Gastrointestinal upset can also be present with secondary hyperparathyroidism.
While the specific physiological mechanisms linking hyperparathyroidism and digestion are unknown, a combination of elevated calcium and sustained PTH production likely plays a role. Too much calcium in the bloodstream may lead to an upset stomach, bloating, and constipation. Abnormal calcium levels can also increase stomach acid production, causing uncomfortable heartburn.
Some of these symptoms can be explained by the fact that hyperparathyroidism causes muscle weakness, as such when the muscles of the intestine become weak and poorly coordinated they may not propel food & waste material down the intestines as easily and therefore cause bloating & constipation. Also the valve muscle above the stomach getting weak will allow acid to reflux up into the esophagus causing heartburn.. Restoring normal PTH levels by treating hyperparathyroidism may reverse this condition.
Poor appetite and weight loss are late findings in hyperparathyroidism, and one of the strong indications for surgery is weight loss, as it indicates that the disease is in an advanced stage.
Diagnosing Hyperparathyroidism and Gastrointestinal Disorders
Hyperparathyroidism is often easier for doctors to explain than diagnose. The symptoms tend to be vague, and no two patients present identically. Some patients may complain of gastrointestinal upset, while others experience few or no digestive issues. Many describe a general feeling of malaise without pinpointing specific symptoms that could lead to a definitive diagnosis.
The complexity of a diagnosis requires the expertise of a physician specializing in parathyroid gland diseases. After a medical history and symptom review, blood tests will analyze calcium and PTH levels, with elevated levels indicating hyperparathyroidism. However, only some patients will present with these results. Others will have elevated calcium and normal PTH or elevated PTH and normal calcium. Experience and expertise are critical to diagnose hyperparathyroidism as the cause of gastrointestinal disorders accurately.
Once diagnosed, the next step is to locate the abnormal parathyroid gland for treatment. Most patients only need treatment for one gland, but some have more than one abnormal parathyroid. Ultrasound or radiation imaging is the most common method of identifying overactive glands.
Managing Hyperparathyroidism and Digestive Disorders
Once patients know the source of their digestive disorders, they can learn how to manage them. While dietary changes and medical treatment can help alleviate symptoms, the only way to “cure” hyperparathyroidism and its accompanying symptoms is by surgery.
Dr. Babak Larian is a board-certified otolaryngologist with extensive experience in parathyroid disorders. Dr. Larian offers patients a minimally invasive parathyroidectomy to remove the abnormal parathyroid gland. The procedure takes place under local anesthetic in less than 20 minutes, with only a tiny incision at the base of the neck.
Patients return home within an hour after surgery. Recovery time is shorter and more comfortable than major surgery and has a low complication rate. Dr. Larian also performs a four-gland assessment during the procedure to ensure the other glands are functioning normally.
If you have uncomfortable symptoms and no diagnosis, contact the CENTER for Advanced Parathyroid Surgery today. Dr. Larian will perform a full assessment to determine the cause of your symptoms. If hyperparathyroidism is the culprit, the top priority is curing your disease with our innovative, minimally-invasive procedure. Contact us online or call now at 310-461-0300.
