What is this frequent stomach ache? Let's learn about Sclerosing Mesenteritis in a simple way!

Do you sometimes feel like you have a stomach ache or a feeling of fullness for no reason? We usually think it's a gas problem or a minor digestive problem, right? But sometimes, there may be a condition behind this that we don't talk about much and has a slightly strange name. Today we are going to talk about one such rare but very important condition to know about. That is Sclerosing Mesenteritis.

Simply put, what is Sclerosing Mesenteritis?

This name may sound a little scary, but let's break it down and understand it simply.

Imagine that the intestines inside our stomach are not just floating here and there, right? There is a membrane that helps keep them in order and in one place. To be precise, our intestines are attached to the back wall of the abdomen by this membrane. We medically call this membrane the mesentery . There is also a layer of fat (adipose tissue) inside this mesentery.

Now look, "Mesenteritis" refers to inflammation of the mesentery. It means a swelling-like condition. The word "sclerosing" means something thickening, or scar tissue forming and thickening. Just like when we have a wound on our skin, after it heals, the skin thickens a little and a scar remains. This is what we call fibrosis .

When the mesentery thickens in this way, it can sometimes look like a tumor on a scan. That's why it's important to know exactly what it is.

Is this a chronic disease?

Yes, absolutely. Because for the scarring that you mentioned to occur and reach the stage of sclerosis, the inflammation has to be continuous for a long time. This doesn't happen all at once. There are several stages to this.

1. First, the fatty tissue in the mesentery begins to break down gradually.

2. Then, different types of cells arrive at that location and begin to gather.

3. Scar tissue begins to form eventually.

Therefore, Sclerosing Mesenteritis is a long-term, progressive disease. But there is one good thing to say here. It does not always get worse. In most cases, it can get better on its own, without any treatment. So don't be afraid to hear the name.

Is this also called Mesenteric Panniculitis?

You may have heard this name before. Mesenteric Panniculitis is an inflammation of the fatty tissue (panniculus) in the mesentery. Simply put, many doctors treat both conditions as the same disease. Because both occur without a specific cause, they are idiopathic inflammations.

However, some doctors believe that the name Sclerosing Mesenteritis should be used for the more severe, scarred stage of the disease. Mesenteric Panniculitis refers to the earlier stage of inflammation, before the scar begins to form. However, these two are generally considered to be different stages of the same disease.

Who is most likely to get this disease?

First of all, Sclerosing Mesenteritis is a very rare condition. It affects a very small number of people, about 0.6% of the population. So don't be unnecessarily afraid of it.

According to the data available, this condition is most commonly seen in:

• Among people over 50 years of age .
• If anyone in the family has autoimmune diseases .
• According to some studies, about 60% of people diagnosed with this disease have or have had other cancers . It has been shown to be associated with a type of cancer called lymphoma .

So is this cancer? A question that scares many people!

This is the most important thing you need to remember. This is not cancer. However, it can be associated with cancer and sometimes looks like cancer on scans. Let's understand that.

Cancer cells are a type of cell that can divide, grow, and spread uncontrollably throughout the body. However, the scar tissue that forms in sclerosing mesenteritis does not divide and spread in this way. However, when the scar tissue accumulates and thickens, it can look like a tumor on a scan. Also, these symptoms can be similar to some cancer symptoms.

For these reasons, a doctor has to perform certain tests to accurately differentiate between these two conditions.

What are the symptoms of this disease?

The surprising thing here is that many people don't have any symptoms . It's often discovered incidentally during a scan done for another reason.

However, if symptoms do occur, the most common are:

• Abdominal pain: A constant feeling of slight pain or discomfort in the stomach.
• Bloating: Feeling of bloating and bloatedness.
• Diarrhea or Fever: These symptoms may occur if the inflammation is severe.
• Feeling a lump in the stomach: Sometimes, when you feel the stomach from the outside, the thickened area can feel like a lump.
• Nausea, vomiting, and weight loss: Very rarely, this thickened tissue can block the small intestine. This is when symptoms such as nausea, vomiting, and weight loss occur.

Why does this kind of disease occur? What is the cause?

To be honest, the exact cause of this has not yet been found , but doctors' main suspicion is that it could be an autoimmune disease .

Simply put, the job of our immune system is to fight off disease-causing germs. But in an autoimmune disease, our own immune system mistakenly starts attacking our own healthy tissues. This attack causes chronic inflammation.

Many people who develop sclerosing mesenteritis have a family history of other autoimmune diseases. It is also believed that the condition can sometimes be triggered by physical stress, such as surgery, infection, or cancer.

How does a doctor diagnose this disease? (Diagnosis)

After listening to your symptoms, if the doctor suspects this disease, he or she will refer you for several tests.

1. Scans (Imaging)

• Ultrasound scan: This is a quick and easy test that can be done to identify early signs.
• CT scan or MRI scan: These are more sensitive tests. These scans can show things like thickening of the mesentery and scar tissue very clearly.
• PET scan: Sometimes it can be difficult to tell from a CT or MRI scan whether it is Sclerosing Mesenteritis or cancer. In such cases, a PET scan can help. Here, a radioactive substance is injected into the body. Since cancer cells absorb this substance more than normal cells, it can be clearly identified if it is cancer.

2. Biopsy

If the above tests are still inconclusive, the final test is a biopsy. In this, a very small piece of tissue is taken from the thickened area of ​​the mesentery and examined under a microscope. This tissue sample is usually taken by inserting a thin needle through the abdomen. In some people, this sample may need to be taken through a minor operation, such as a laparoscopy.

What are the treatments for this?

The good news is that most people don't need any treatment . This condition often resolves on its own. If you have no symptoms, or are experiencing only mild discomfort, your doctor may recommend that you don't take any medication and just wait it out.

However, if symptoms persist or interfere with your daily life, there are several medications that your doctor may prescribe.

• Corticosteroids: For example, Prednisone. These control inflammation in the body.
• Immunosuppressants: For example, azathioprine. These work by reducing the activity of the immune system that is malfunctioning.
• Hormonal therapy: Medications such as Tamoxifen are also sometimes used.

Can this condition be controlled with food and drink?

Following an anti-inflammatory diet can help reduce inflammation in the body, especially in the digestive system. This may not cure Sclerosing Mesenteritis completely , but it can help control symptoms to some extent.

Simply put, an anti-inflammatory diet is:

• Prioritizing natural, fresh foods (whole foods) instead of packaged, processed foods.
• Eating more foods containing healthy, unsaturated fats (e.g., omega-3).
• Adding more fresh vegetables, fruits, and herbs to your diet.

It's best to talk to your doctor about this and, if necessary, seek the advice of a nutritionist.

Sclerosing Mesenteritis, abdominal pain, abdominal distension, Mesenteric Panniculitis, autoimmune disease