Mesenteric Panniculitis: Stomach Pain, Causes, Treatment - Verywell Health
Mesenteric panniculitis—also known as sclerosing mesenteritis—is a rare and chronic illness. It causes inflammation and scarring of the fatty tissue of your mesentery. Mesentery is a fold of membranes that anchors your small intestine to your abdominal wall.
Symptoms may or may not be present with mesenteric panniculitis. When symptoms occur, they can vary from mild to harsh. They often involve nonspecific stomach pain that can also be due to other problems. This can make the illness hard to determine early.
Symptoms can affect your daily life, but treatment may or may not be needed based on the cause of the problem. It can sometimes resolve on its own.
This article describes mesenteric panniculitis symptoms, causes, diagnosis, and treatment.
Prostock-Studio / Getty Images
Describing Abdominal Pain From Mesenteric Panniculitis
Mesenteric panniculitis can occur without symptoms. It is possible to have this condition with few or no noticeable symptoms.
When symptoms occur, they can be chronic (long-lasting) or acute (sudden and short term). Symptoms are not specific to this disease and can vary based on the size and location of scarring or a mass.
The most common symptom involves chronic or intermittent abdominal pain. Research indicates this symptom occurs in about 72% of people with mesenteric panniculitis. Other symptoms common with this condition include the following:
What Causes Inflammation in Mesenteric Panniculitis?
The cause of mesenteric panniculitis is unknown. The inflammation occurs independently of other disorders. However, it is believed to be associated with a wide range of diseases, including the following:
You may have a higher risk of developing mesenteric panniculitis if you have one of the following characteristics:
- Male (a male-to-female disease ratio of 2- or 3-to-1)
- Being White
- Age of 60–70 years
- Prior abdominal surgery
- Abdominal trauma
- Cancer
- Chemotherapy
Mesenteric Panniculitis vs. Mesenteric Adenitis
Mesenteric panniculitis and mesenteric adenitis are distinct diseases affecting your mesentery organ in the following ways:
- Mesenteric panniculitis causes persistent and long-term inflammation of your mesentery. It often affects older adults, especially men.
- Mesenteric adenitis is a short-lived condition linked to viral gastroenteritis (stomach "flu") or a respiratory illness. It is most likely to affect children, adolescents, and young adults.
How Do Providers Diagnose Mesenteric Panniculitis?
Your healthcare provider will use several procedures to diagnose mesenteric panniculitis as the cause of your symptoms. These include the following:
- Physical examination: In a physical exam, your healthcare provider will take your medical and family histories and discuss your symptoms. Abdominal tenderness may be detected during the physical exam.
- Blood tests: The results of laboratory tests are usually normal in cases of mesenteric panniculitis. In some cases, a high rate of erythrocyte sedimentation (sed rate) and C-reactive protein, which are markers of inflammation, have been observed.
- Abdominal computed tomography (CT) scan: A CT scan uses multiple X-ray images to create a three-dimensional (3D) image. An abdominal CT scan with intravenous (IV) contrast is the most sensitive type of mesenteric panniculitis radiology. The condition is characterized by a soft-tissue mass with a fatty halo sign around the mass.
- Magnetic resonance imaging (MRI): An MRI uses a magnetic field and radio waves to produce two-dimensional (2D) or 3D images of the structures inside your body. It can provide evidence of a mass in your mesentery and the characteristic fatty halo ring.
- Open biopsy: An open biopsy is a surgical procedure that involves making an incision to obtain a tissue sample from the mesentery. A biopsy is the gold standard for diagnosing mesenteric panniculitis. It is usually done during exploratory laparoscopy, a minimally invasive surgery.
- Positron-emission tomography (PET)/computed tomography (CT) scan: A PET/CT scan is used to diagnose mesenteric panniculitis when the results of other imaging tests are inconclusive. It can rule out cancer when the diagnosis of mesenteric panniculitis is inconclusive.
In cases of asymptomatic mesenteric panniculitis, the condition may be diagnosed during a CT scan or MRI of your abdomen for another reason.
Could Chronic Stomach Pain Be Mesenteric Panniculitis or Something Else?
Chronic stomach pain with mesenteric panniculitis does not define the disease. Many causes of abdominal pain range from harmless to serious conditions. In diagnosing mesenteric panniculitis, your healthcare provider considers your symptoms, the results of medical tests, and additional input about your condition and history to rule out the causes of your illness.
A differential diagnosis—the process of differentiating between two or more conditions with similar symptoms—is performed to eliminate certain causes, such as the following:
Treatment for Mild Mesenteric Panniculitis Symptoms
The management and treatment of mesenteric panniculitis symptoms usually involve the services of a gastroenterologist, a healthcare provider specializing in diagnosing and treating digestive tract and liver conditions. Radiologists (diagnose and treat conditions using medical imaging), surgeons, and pathologists (examine body tissue and perform lab tests) may also be involved in your treatment.
Asymptomatic mesenteric panniculitis is usually not treated. It is often handled with a watchful waiting approach, which involves active monitoring by a healthcare provider to observe whether the disorder progresses before treating it. In many cases, the condition improves on its own.
There is no consensus on the treatment for mesenteric panniculitis. The severity of your symptoms and complications determines options.
Symptoms of mild mesenteric panniculitis symptoms without other causes can often be treated with the following medications:
Treatment for Severe Mesenteric Panniculitis Obstruction
Treatment for severe mesenteric panniculitis obstruction involves a surgical technique called resection surgery. This involves removing part or all of the intestinal obstruction. It can be done using open surgery or laparoscopic surgery.
However, surgery is generally not advised because the disease is typically self-limiting (resolves on its own). It is avoided whenever possible except for diagnostic sampling or in the presence of life-threatening complications like a bowel obstruction. In most cases, surgery is controversial and is not attempted to cure mesenteric panniculitis.
Recovery/General Outlook for Mesenteric Panniculitis
The outlook for most cases of mesenteric panniculitis is good. The disease commonly stays asymptomatic and remains stable. It may even improve on its own without treatment.
Generally, mesenteric panniculitis is not life-threatening and rarely causes complications. In one retrospective study, drug therapy resolved the disease, with no recurrence in up to two years of follow-up.
Anti-Inflammatory Mesenteric Panniculitis Diet
While there is no specific mesenteric panniculitis diet, following a general anti-inflammatory diet may help reduce symptoms related to inflammation. An anti-inflammatory diet involves increasing your intake of foods that reduce inflammation, such as the following:
- Brussels sprouts, cabbage, broccoli, cauliflower, and other cruciferous vegetables
- Blueberries, raspberries, pomegranates, cherries, and other deeply colored fruits
- Kale, spinach, and other leafy green vegetables
- Oats, brown rice, barley, quinoa, and other unrefined whole grains
- Legumes like lentils, chickpeas, and black, pinto, or kidney beans
- Olive oil and avocados
- Nuts and seeds
- Oily fish like mackerel, sardines, or salmon
- Unsweetened green or black tea
- Turmeric, ginger, garlic, cinnamon, and other herbs and spices
- Dark chocolate
Following an anti-inflammatory diet also involves avoiding the following foods:
- Steaks, burgers, and other red meats
- Bacon, hot dogs, sausages, and other processed meats
- White bread, white pasta, bagels, and other foods made with white flour
- Ready-to-eat meals and frozen dinners
- Cookies, donuts, cakes, and other sweet baked goods
- Chips, crackers, and other packaged salty snack foods
- Soda and other sweetened beverages
- French fries, fried fish, fried chicken, and other fried foods
- Highly processed foods made with margarine, soybean, corn, or cottonseed oil
- Saturated fats
- Added sugar and excess salt
- White rice and other refined (white) carbohydrates
- Additives and other artificial preservatives, flavors, and color
Summary
Mesenteric panniculitis is a rare disease that causes inflammation and scarring of the fatty tissue of your mesentery, the tissue that holds your small intestine to your abdominal wall. While this illness is benign, it is chronic.
Some people have this condition but do not experience symptoms. It is often found during imaging tests for other issues. When it occurs without symptoms, treatment is not needed.
Others have symptoms that involve stomach pain and annoying issues that affect the digestive tract. These problems can vary from mild to harsh. Relief of symptoms is usually achieved with drug therapy.
While the cause of this problem is unknown, it is thought to be linked to many known conditions. Complications are rare. Surgery may be needed when problems like an intestinal blockage occur.
:max_bytes(150000):strip_icc()/IMG_09172-9ca0040fa5e74df0b5aac42d8125d477.jpeg)
Comments
Post a Comment