A rare health condition that researchers continue to study is called mesenteric panniculitis. It causes long-term (chronic) inflammation in connective tissue in the abdomen (also known as mesentery tissue). People who develop it often experience scarring of the tissues in the abdominal cavity. Unfortunately, there is no way to cure it because doctors do not fully understand what exactly causes it, but there are some medicines that may help with symptoms.
In normal circumstances, the mesentery contains blood vessels that supply the organs and tissues in the abdominal area with blood. Furthermore, it is a part of the peritoneum, which is a tissue that lines the abdominal cavity and covers the organs inside. In people with mesenteric panniculitis, the adipose (body fat) tissue layer is affected, which causes long-term inflammation and may cause fat cells to die (also known as fat necrosis). Thus, it may lead to fibrosis (scarring) of the issues. In addition, this condition appears spontaneously, which means it is not caused by infections, injuries, or cancer.
According to some research, about 1.5% of people are affected by this condition worldwide. Frequently, this condition is underdiagnosed because it does not always cause symptoms.
What is The Difference between Mesenteric Panniculitis and Sclerosing Mesenteritis?
While most believe these conditions are the same, some suggest that sclerosing mesenteritis is a more severe or advanced form of mesenteric panniculitis. Nowadays, experts believe that mesenteric panniculitis is a treatable condition, but sclerosing mesenteritis cannot be cured and may worsen over time.
Doctors do not know what exactly causes mesenteric panniculitis. That’s why they do not understand why a person experiences more severe symptoms than the other.
Symptoms
While this condition may not cause any symptoms, some people may experience the following ones. Check some examples below:
- Abdominal bloating, swelling, or pain (the most common symptoms)
- Loss of appetite or early satiety
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Weight loss
If any of the previous symptoms occur, immediately contact your healthcare professional. In addition, this condition may also cause systemic symptoms that have negatively affected the whole body. These include fever and extreme tiredness (fatigue), which are often common when the immune system is involved.
Causes
Commonly, people develop this condition due to certain infections, injuries, or some types of cancer. However, about 5% of diagnosed cases occur after abdominal surgery. Inflammation is often an immune system response that is supposed to help tissue heal and fight off things that can make you ill.
When the immune system causes a chronic (long-term) inflammatory response without an existing disease or injury, doctors call it an “autoimmune response”. In such cases, the immune system reacts automatically and inappropriately. That’s why some healthcare professionals think mesenteric panniculitis is an autoimmune disorder. Generally, autoimmune conditions tend to run in families, and people with mesenteric panniculitis have a strong family history of autoimmune disorders. Sometimes, these conditions are triggered by a temporary disease that causes an immune system reaction. Check below for other possible causes of mesenteric panniculitis:
Infections
Sometimes, people develop this condition after an infection. Check some examples below:
- Tuberculosis
- Syphilis
- Cholera
- Whipple’s disease
- Typhoid fever
Cancer
People who were recently treated for cancer may also develop mesenteric panniculitis. It accounts for about 30% of cases. The following types of cancer are often associated with mesenteric panniculitis. Examples include:
- Lymphoma
- Carcinoid tumors
- Colon cancer
- Kidney cancer
- Prostate cancer
Other Sclerosing Disorders
In some cases, people develop mesenteric panniculitis because they already have similar conditions. These disorders often cause long-term inflammation and progressive scarring (sclerosis or fibrosis). Check some examples of other sclerosing conditions below:
- Sjogren’s syndrome
- Retroperitoneal fibrosis
- Sclerosing pancreatitis
- Nodular panniculitis
- Crohn’s disease
Diagnosis
Usually, it is difficult to diagnose this condition because its symptoms resemble those of other diseases. That’s why doctors diagnose this condition by ruling out many other more common conditions that cause these symptoms. In any case, the diagnosis begins with a physical examination and questions about the symptoms and medical history. Thereafter, physicians will perform the following tests and procedures to confirm or exclude mesenteric panniculitis. For example:
- Blood tests – Doctors often perform these tests to check for inflammation.
- Imaging tests – The following tests are used to get detailed images of different structures and organs in the body. Doctors often perform MRI (magnetic resonance imaging) scans or CT (computed tomography) scans. These tests may show signs of fat necrosis and fibrosis.
- Biopsy – During this test, doctors will take a small sample of the affected tissue for testing.
Treatment
While physicians prescribe different treatments for people with mesenteric panniculitis, some people with this disorder do not need treatment (such as when a person does not have symptoms or has mild ones). Most of the time, this disorder does not worsen over time and disappears on its own. Check below some options used to treat mesenteric panniculitis if you have symptoms:
- Corticosteroids – In general, this group of medications is primarily used to reduce inflammation, and it is often the main treatment for people with mesenteric panniculitis. Sometimes, physicians may recommend other medicines to relieve the symptoms (such as nausea).
- Immunosuppressants – These medicines are used to suppress the immune system that overreacts and causes inflammation in the body. In rare cases, doctors may prescribe a low-dose Naltrexone (LDN) to modulate the immune system.
Can Diet Help Manage Mesenteric Panniculitis?
Usually, doctors may recommend an anti-inflammatory diet along with the previous medicines. While the diet is not enough to get rid of inflammation, it may improve the effectiveness of the treatment and ease the symptoms. Check below some foods that you should avoid if you have mesenteric panniculitis:
- Red and processed meats
- Fried foods
- High-sugar products (such as soda)
- Alcohol
- Saturated fats (including margarine)
- Refined carbohydrates (such as white bread)
- Packaged snacks and others
In most cases, doctors recommend including in your diet the following foods. Examples include:
- Leafy green vegetables
- Whole fruits, grains, and vegetables
- Plant oils (such as olive oil, canola oil, and others)
- Turmeric
- Nuts (including almonds and walnuts)
Furthermore, the Mediterranean diet is also an anti-inflammatory diet that includes whole foods and healthy sources of omega-3 fatty acids.
Frequently Asked Questions
Is mesenteric panniculitis serious?
In general, this condition is not life-threatening, and it rarely causes serious complications. Mostly, people with this disorder have mild symptoms that often disappear on their own. However, in rare cases, people may develop digestive problems that can obstruct the small intestine. For more details, discuss it with your doctor.
Who does mesenteric panniculitis affect?
While anyone may develop this condition, it mostly affects older adults (over 60 years old). Moreover, some research suggests that mesenteric panniculitis is more common in males than in females.
What is the prognosis of mesenteric panniculitis?
Most people who develop this condition do not have serious complications, and they often do not need treatment. In rare cases, this condition may cause some chronic (long-term) symptoms. If you have any other questions, ask your healthcare provider.
