Hypersecretion

Hypersecretion is the excessive production or discharge of a substance by a gland or mucosal surface, resulting in higher levels in secretions than normal. It can arise from increased synthesis, heightened release, glandular hyperplasia, or impaired reabsorption, and may be driven by hormonal stimulation, inflammation, infection, toxins, or neoplasia. The clinical impact depends on the substance and site, ranging from dehydration and electrolyte disturbances to organ dysfunction and characteristic symptoms such as diarrhea, productive cough, or peptic ulcers.

Examples span several organ systems. In the gastrointestinal tract, gastric acid hypersecretion from gastrin-secreting tumors (gastrinoma) or mucosal hyperplasia can cause peptic ulcers. Secretory diarrhea occurs with toxins from infections, and with hormone-secreting tumors such as vasoactive intestinal peptide (VIP)–secreting tumors, leading to large-volume watery stools. In the respiratory tract, mucus hypersecretion is common in chronic bronchitis and asthma, producing productive cough and airway obstruction. Nasal and sinus mucous hypersecretion occur in allergic rhinitis and chronic rhinosinusitis. In endocrine disorders, tumors or dysregulated signaling can cause excessive production of peptides or hormones, with systemic effects depending on the mediator.

Diagnosis integrates history, laboratory measurement of secretions or hormones, stool studies to distinguish secretory from osmotic diarrhea, and imaging to identify neoplasms. Treatment targets the underlying cause when possible and includes acid-suppressive therapy for gastric hypersecretion, therapy or surgery for hormone-secreting tumors, mucolytics and bronchodilators for mucus hypersecretion, and supportive care as needed.