The most common reason in this age of loose motion
, not responding to conventional medicines is paraneoplastic syndrome
where VIP, vasodilators and somatostatin are secreted from various cancers, most common being neuro endocrine tumors and carcinoids arising in GI, Head pancreas, lung. These chemicals can be detected on urine examine.
Chemicals against these causative agents are available and immediately started
As for treatment is concerned in her age, immediate correction of dehydration
and electrolytes should be corrected and lomotil or Imosac or lopramidi 2 tab stat followed by 8 -6 hourly should be tried until primary tumor
is detected and imaging, preferably PET-CT Scan and removed.
In view of her age, if surgery is not possible, a palliative dose of Radiotherapy about 30Gy in 10 fractions in 2 weeks should be considered after pathological confirmation by 3DCRT or IMRT may wonderfully improve the symptoms.
These tumors are relatively radio and chemo resistant. In view of her ase, chemotherapy
should not be considered at all.
Dr. Vinay Kumar,
Senior Consultant Oncology and Radiotherapy