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What Is Mesenteric Panniculitis?
Question: Hi I would like to know what is mesentric panniculitis ? And the treatment for the same.
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing in to us.
I have read through your query in detail.
Mesenteric panniculitis is a rare autoimmune condition with the exact cause remaining unknown. Research has shown a strong relationship between tobacco use and mesenteric panniculitis.
It mainly appears as an inflammation of the fat attached to the intestines and the symptoms vary with each patient and may include abdominal tenderness, anorexia, abdominal pain, abdominal fullness, nausea, fever, and weight loss. Ultrasounds and CT scans are the most common imaging tests showing a thickening of the mesentery (fat attached to intestines). Often biopsy or open surgery is required to make a confirmed diagnosis.
The condition can be said to occur in 3 stages as per the nature of cells found at biopsy.
The first stage is mesenteric lipodystrophy shows altered fat tissue.
The second stage, termed mesenteric panniculitis shows build up of certain types of white blood cells and is accompanied with symptoms like fever, abdominal pain and weakness.
The third stage is retractile mesenteritis and cells show collagen deposition, fibrosis, and inflammation.
Treatment of this condition depends on its stage. Treatment has been attempted with a variety of drugs including steroids, cyclophosphamide, colchicine, azathioprine, tamoxifen, or radiotherapy, with different degrees of success. Surgery is recommended only for advanced irreversible inflammatory changes or in cases of bowel obstruction. However, 1 in 5 patients getting treated may have the condition for a longer duration.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing in to us.
I have read through your query in detail.
Mesenteric panniculitis is a rare autoimmune condition with the exact cause remaining unknown. Research has shown a strong relationship between tobacco use and mesenteric panniculitis.
It mainly appears as an inflammation of the fat attached to the intestines and the symptoms vary with each patient and may include abdominal tenderness, anorexia, abdominal pain, abdominal fullness, nausea, fever, and weight loss. Ultrasounds and CT scans are the most common imaging tests showing a thickening of the mesentery (fat attached to intestines). Often biopsy or open surgery is required to make a confirmed diagnosis.
The condition can be said to occur in 3 stages as per the nature of cells found at biopsy.
The first stage is mesenteric lipodystrophy shows altered fat tissue.
The second stage, termed mesenteric panniculitis shows build up of certain types of white blood cells and is accompanied with symptoms like fever, abdominal pain and weakness.
The third stage is retractile mesenteritis and cells show collagen deposition, fibrosis, and inflammation.
Treatment of this condition depends on its stage. Treatment has been attempted with a variety of drugs including steroids, cyclophosphamide, colchicine, azathioprine, tamoxifen, or radiotherapy, with different degrees of success. Surgery is recommended only for advanced irreversible inflammatory changes or in cases of bowel obstruction. However, 1 in 5 patients getting treated may have the condition for a longer duration.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi
CT SCAN is done and the report says well circumscribed in homogenous hyper attenuating focal fatty mesenteric area with few sub centimetre soft tissue attenuating nodules at left upper abdomen extending from root of mesentery to jejunal surface (jejunal mesentry) -s/o mesenteric panniculitis .
Few mild enlarged nonspecific bilateral para aortic lympnodes.
Normal bowel loops.
Normal SMV & SMA
sections at lower chest shows small calcified nodular opacity at lateral basal segment of left lower lobe -s/o calcified granuloma.
Question: at this stage what can be done to get rid of this disease.
CT SCAN is done and the report says well circumscribed in homogenous hyper attenuating focal fatty mesenteric area with few sub centimetre soft tissue attenuating nodules at left upper abdomen extending from root of mesentery to jejunal surface (jejunal mesentry) -s/o mesenteric panniculitis .
Few mild enlarged nonspecific bilateral para aortic lympnodes.
Normal bowel loops.
Normal SMV & SMA
sections at lower chest shows small calcified nodular opacity at lateral basal segment of left lower lobe -s/o calcified granuloma.
Question: at this stage what can be done to get rid of this disease.
Brief Answer:
It can resolve by itself, please treat symptoms
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Your condition is in the earliest stages. Most likely it will get better by itself.
I have reviewed research literature in medicine and it says that..
1. Mesenteric panniculitis resolves spontaneously in most cases, however, palpable masses may often be found between 2 and 11 years after diagnosis, especially in patients with associated problems. In such cases, several types of treatment have been proposed but no consensus has been established.
2. In general, treatment has been reserved for symptomatic cases. Incidental masses may be observed and left untreated.
3. Therapy is individualized on a case by case basis. Treatment may be attempted with a variety of drugs including steroids, thalidomide, cyclophosphamide, progesterone, colchicine, azathioprine, tamoxifen, antibiotics and emetine, or radiotherapy, with different degrees of success.
4. Surgery may be attempted if medical therapy fails or in the presence of life-threatening complications such as bowel obstruction or perforation.
After having read through your query, I feel that it is recently that you have developed the symptoms. Since in most patients the disease gets controlled by itself, I hope you are also one among them.
Should you have any symptoms, then it must be treated in a way to decrease your discomfort.
It is important that you stop using tobacco in any form if you are a smoker or tobacco chewer.
The lung nodule is not significant.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
It can resolve by itself, please treat symptoms
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Your condition is in the earliest stages. Most likely it will get better by itself.
I have reviewed research literature in medicine and it says that..
1. Mesenteric panniculitis resolves spontaneously in most cases, however, palpable masses may often be found between 2 and 11 years after diagnosis, especially in patients with associated problems. In such cases, several types of treatment have been proposed but no consensus has been established.
2. In general, treatment has been reserved for symptomatic cases. Incidental masses may be observed and left untreated.
3. Therapy is individualized on a case by case basis. Treatment may be attempted with a variety of drugs including steroids, thalidomide, cyclophosphamide, progesterone, colchicine, azathioprine, tamoxifen, antibiotics and emetine, or radiotherapy, with different degrees of success.
4. Surgery may be attempted if medical therapy fails or in the presence of life-threatening complications such as bowel obstruction or perforation.
After having read through your query, I feel that it is recently that you have developed the symptoms. Since in most patients the disease gets controlled by itself, I hope you are also one among them.
Should you have any symptoms, then it must be treated in a way to decrease your discomfort.
It is important that you stop using tobacco in any form if you are a smoker or tobacco chewer.
The lung nodule is not significant.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Today, a gastro enterologist advised us to have ct entero clysis. What does this test show. Is it needed at this stage. Kindly tell us , is there any diet suggestions to control mesenteric paniculites .
Brief Answer:
CT enteroclysis helps to evaluate intestinal lumen
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
CT enteroclysis is a study by which the lumen of the intestines will be evaluated. They will insert a thin tube through nose and into stomach and distend the intestine with fluids and take CT scan. It is done in cases where there can be a doubt about any intestinal wall thickening. In your case, I think the doctor wants to clear doubt whether you have any intestinal wall thickening. This is to know if there is any hidden disease like lymphoma (a type of cancer) in the intestine which is causing the nodules in the mesentery at the root of jejunum.
Since you are consulting gastroenterologist, he wants to be very sure about the diagnosis and guide you properly with treatment.
Taking a higher amount of liquids in diet helps the patient in recovery from symptoms.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
CT enteroclysis helps to evaluate intestinal lumen
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
CT enteroclysis is a study by which the lumen of the intestines will be evaluated. They will insert a thin tube through nose and into stomach and distend the intestine with fluids and take CT scan. It is done in cases where there can be a doubt about any intestinal wall thickening. In your case, I think the doctor wants to clear doubt whether you have any intestinal wall thickening. This is to know if there is any hidden disease like lymphoma (a type of cancer) in the intestine which is causing the nodules in the mesentery at the root of jejunum.
Since you are consulting gastroenterologist, he wants to be very sure about the diagnosis and guide you properly with treatment.
Taking a higher amount of liquids in diet helps the patient in recovery from symptoms.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the detailed explanation.
My symptoms are pain left side below the ribs and constipation these symptoms are from a very long period of time about 15 yrs.
What are the other tests where Lymphoma can be ruled out? Any marker tests?
Is it a must to get tested for lymphoma ..? What are the other tests to rule out the mesentric panniculitis ? I have concern here I would like to know why the gastro is not giving any medicines? Are there any medicines to start with for the mesentric panniculitis ??
My symptoms are pain left side below the ribs and constipation these symptoms are from a very long period of time about 15 yrs.
What are the other tests where Lymphoma can be ruled out? Any marker tests?
Is it a must to get tested for lymphoma ..? What are the other tests to rule out the mesentric panniculitis ? I have concern here I would like to know why the gastro is not giving any medicines? Are there any medicines to start with for the mesentric panniculitis ??
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
I can understand that you are suffering from this condition for 15 years but would be interested in knowing what are the treatments you have taken in the last 15 years and how many times has the condition required hospital admission and treatment.
Lymphoma and other malignancies can be present in 15 percent of the patients on a long term basis. It means for every 100 patients diagnosed with mesenteric panniculitis, 85 eventually get better and have mild symptoms.
Lymphoma can be fully confirmed only by biopsy. For this there must be bowel wall thickening, a mass or sufficient number of enlarged lymphnodes which can be tested by biopsy.
Its not a must to get tested for lymphoma but as you are aware, no stone must be left unturned and the gastroenterologist just wants to be 100 percent sure nothing was missed on imaging.
Even mesenteric panniculitis can be confirmed 100 percent only by biopsy but most of the time, in the absence of other clinical signs, doctors go for a more conservative approach in treatment, especially when the patient is having the symptoms for many years as in your case.
Steroids are the first class of medications started by many doctors but taking oral steroids has its own benefits and side effects. This is the reason it must be taken under supervision of the treating doctor only to avoid complications.
The gastroenterologist just wants to be sure if he should start on steroids and similar medications or give time for it to heal by itself, considering risks and benefits of treatment with steroids and other medications. There are a very limited group of medications which can be given and each has its own advantages and disadvantages.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
I can understand that you are suffering from this condition for 15 years but would be interested in knowing what are the treatments you have taken in the last 15 years and how many times has the condition required hospital admission and treatment.
Lymphoma and other malignancies can be present in 15 percent of the patients on a long term basis. It means for every 100 patients diagnosed with mesenteric panniculitis, 85 eventually get better and have mild symptoms.
Lymphoma can be fully confirmed only by biopsy. For this there must be bowel wall thickening, a mass or sufficient number of enlarged lymphnodes which can be tested by biopsy.
Its not a must to get tested for lymphoma but as you are aware, no stone must be left unturned and the gastroenterologist just wants to be 100 percent sure nothing was missed on imaging.
Even mesenteric panniculitis can be confirmed 100 percent only by biopsy but most of the time, in the absence of other clinical signs, doctors go for a more conservative approach in treatment, especially when the patient is having the symptoms for many years as in your case.
Steroids are the first class of medications started by many doctors but taking oral steroids has its own benefits and side effects. This is the reason it must be taken under supervision of the treating doctor only to avoid complications.
The gastroenterologist just wants to be sure if he should start on steroids and similar medications or give time for it to heal by itself, considering risks and benefits of treatment with steroids and other medications. There are a very limited group of medications which can be given and each has its own advantages and disadvantages.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer....
I am not having habit of using tobacco in any form and I am purely vegetarian doing yoga. I have been never admitted in hospital for treatment. And this was known before only one year after that I have taken many antibiotics pre and pro biotics etc (not steriods) there was no progress...now am taking daily one bio-c tablet and fiber powder of amway and also doing swimming daily and I feel little better now.
As oral steroids have side effects is there any steroidal ointment that can be safe in treating dieases and are there any medicines in ayurveda/homeopathy/unani/naturopathy...etc...
What else can you suggest/advice as I am very much concerned on my problem.
Awaiting your reply......
I am not having habit of using tobacco in any form and I am purely vegetarian doing yoga. I have been never admitted in hospital for treatment. And this was known before only one year after that I have taken many antibiotics pre and pro biotics etc (not steriods) there was no progress...now am taking daily one bio-c tablet and fiber powder of amway and also doing swimming daily and I feel little better now.
As oral steroids have side effects is there any steroidal ointment that can be safe in treating dieases and are there any medicines in ayurveda/homeopathy/unani/naturopathy...etc...
What else can you suggest/advice as I am very much concerned on my problem.
Awaiting your reply......
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Since it is only a recent happening, little over a year, chances are that it will get resolved besides you also say that things are looking better after yoga and swimming. I suggest you to continue that and swimming and yoga have several health benefits.
Steroid ointments will not work much because the problem is inside the abdomen and steroid in ointment for is very low in concentration and may not reach the disease parts.
This disease condition is a specific entity described in allopathic medicine and evidence lies in appearance as found in CT scan imaging.
There are many treatments available in ayurveda and homeopathy for intestinal problems but this particular condition is rare and unique. Homeopathy is a better option for some conditions and if you get benefit from it then that is good.
At the same time I will recommend that you also discuss the treatment with the gastroenterologist and then take an informed decision on your treatment.
Many of these conditions can also be controlled by diet and being stress free. Since you are a vegetarian, you can take more semisolid foods if you have pain any time. Doing yoga is already keeping your mind healthy. Please do not worry much and make a note of your health problems in a diary so that we can know the problems you are having over time.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Since it is only a recent happening, little over a year, chances are that it will get resolved besides you also say that things are looking better after yoga and swimming. I suggest you to continue that and swimming and yoga have several health benefits.
Steroid ointments will not work much because the problem is inside the abdomen and steroid in ointment for is very low in concentration and may not reach the disease parts.
This disease condition is a specific entity described in allopathic medicine and evidence lies in appearance as found in CT scan imaging.
There are many treatments available in ayurveda and homeopathy for intestinal problems but this particular condition is rare and unique. Homeopathy is a better option for some conditions and if you get benefit from it then that is good.
At the same time I will recommend that you also discuss the treatment with the gastroenterologist and then take an informed decision on your treatment.
Many of these conditions can also be controlled by diet and being stress free. Since you are a vegetarian, you can take more semisolid foods if you have pain any time. Doing yoga is already keeping your mind healthy. Please do not worry much and make a note of your health problems in a diary so that we can know the problems you are having over time.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer
I have heard taking country cow morning urine half cup will treat the disease. Is it any harmfull.and I state that the pain will be on and off and the gravity of pain is same from fifteen years what you understood by this.i welcome your suggestion and advice.
I have heard taking country cow morning urine half cup will treat the disease. Is it any harmfull.and I state that the pain will be on and off and the gravity of pain is same from fifteen years what you understood by this.i welcome your suggestion and advice.
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Drinking cow morning urine might be mentioned in ayurveda but I am not aware of its curative properties in your case. In allopathy medicine, ingestion of cow urine is not mentioned any where.
The pain coming you are intermittently having for 15 years makes me think that it is not a very serious issue at the moment but I will suggest that you take opinion from the gastroenterologist and then discuss the advantages and disadvantages taking into account your symptoms and improvement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX
Thanks for writing back with an update.
Drinking cow morning urine might be mentioned in ayurveda but I am not aware of its curative properties in your case. In allopathy medicine, ingestion of cow urine is not mentioned any where.
The pain coming you are intermittently having for 15 years makes me think that it is not a very serious issue at the moment but I will suggest that you take opinion from the gastroenterologist and then discuss the advantages and disadvantages taking into account your symptoms and improvement.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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