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37 years old with mesenteric panniculitis. Have chronic abdominal pain. What are the complications?

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General & Family Physician
Practicing since : 2009
Answered : 983 Questions
I am 37 years old with Mesenteric Panniculitis. I have chronic abd pain. My medical hx includes Seizures (free for 12 years), H pylori (treated in 2008), ITP s/p splenectomy, cholecystectomy, recent dx of Hashimotos. My question regarding Mesenteric Panniculitis is if any research has shown gluten to be a factor. I have been tested negative for Celiacs but I am suspicious of being gluten intolerant as my pain worsens with gluten and the intensity lasts for weeks. If I do not eat gluten, the pain diminishes and the symptoms of the Mesenteric Panniculitis seem to lessen as well without ever truly going away. I am fearful of this progressing to a more fibroid situation leading to other complications and I just want to treat it and avoid any potential triggers for it if that is the case.
Posted Mon, 20 Aug 2012 in Abdominal Pain
Answered by Dr. Aparna Kohli 2 hours later
Thanks for writing in.
Although there is no connection between mesentric panniculitis and gluten, there have been some case reports where this disease has been thought to originate from undiagnosed celiac disease. If that is the case, gluten restriction will help control the symptoms. Since there is no really way of finding out whether the disease came from celiac in your case, I would suggest that you restrict gluten if it provides relief. However, it has been linked with tobacco, peptic ulcer disease and gall bladder disease. So a healthy lifestyle is a must. However, I would like to let you know that this disease resolves in a majority of cases.
Still, I have one underlying concern. This disease is common in men in their 60s and 70s and is not such a common issue overall. Could you please share a few details on how the diagnosis was made in your case? There is a long list of things that needs to be excluded to come to this disease and I was just wondering if each one of those was ruled out? We dont want to be missing out anything in the long term.
Awaiting your reply
Above answer was peer-reviewed by
Follow-up: 37 years old with mesenteric panniculitis. Have chronic abdominal pain. What are the complications? 14 hours later
Thanks for your response. I was diagnosed by CT scan in 2008 and it was an accidental find. They were looking for an appendicitis and found this issue instead. I was on Tamoxifen and Prednisone for 6 months with minimal relief and the discomfort has been an ongoing concern. What prompted me to ask is the fact that I live in Arizona and have developed my first kidney stone 2 weeks ago and they saw Mesenteric Panniculitis on that scan as well. I have completed a lot of research as I am an ER nurse by profession and I love research but my fear is exactly what you stated about the statistics. I can not seem to find anyone that knows much about this that can really help me. I do have a copy of the CT scan from 2008 and the GI workup as well. Any advice you can give me would be greatly appreciated! Thank you in advance for your help.
Answered by Dr. Aparna Kohli 58 minutes later
Thanks for writing back.
A CT scan is really the best way to pick up mesentric pannicultis. But this is a diagnosis of exclusion and we would need to rule out things like inflammatory bowel disease and extra abdominal fat necrosis as well. If you can share your reports with me, I think I can provide an unbiased view of the whole situation. Also, I would like to know if a colonoscopy was done? If so, what were the reports? Please use the 'Upload your reports' section on the right. We'll be able to have a better discussion then
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Follow-up: 37 years old with mesenteric panniculitis. Have chronic abdominal pain. What are the complications? 47 hours later
Dr. XXXXXXX ..I had a difficult time uploading the documents. I do have the ER note as well as the GI consult and surgical consult. What I did send was the Endo/colonoscopy and the CT results.
Answered by Dr. Aparna Kohli 1 hour later
I have seen your reports. Despite the fact that I did not major in gastroenterology or radiology, I still think that your CT findings do not correlate with mesentric panniculitis. This disorder would typically cause anything between a well-defined soft tissue mass to ill-defined areas of higher attenuation in the mesenteric fat.
This is not what your CT report says and I would strongly recommend getting a second opinion here. If your initial description of symptoms and your investigation reports do not match with this disorder, at present, we should be considering other diagnosis as well.
I hope that answers your query.
Let me know if you have any more questions.
Else, please close this discussion.
I hope I was able to help.
Above answer was peer-reviewed by
Follow-up: 37 years old with mesenteric panniculitis. Have chronic abdominal pain. What are the complications? 3 minutes later
Thank you. I believe it is related to gluten even though my celiacs test was negative but I will follow a gluten free diet to be certain. Thanks for your input.
Answered by Dr. Aparna Kohli 7 hours later
I believe its related to the gluten too. We should be considering the tissue transglutaminase IgA, endomysial IgA, and reticulin IgA to totally rule out this condition.
Hope that helps.
Let me know if you have any more questions
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