Stomach structure creates bellyache

Dear Dr. Roach: After a stomach probe two years ago, I was told that I have mesenteric panniculitis. I know it’s inflammation of the stomach lining and that there’s no known cause. So, what can I do? Are there special foods I should eat or stay away from? I wasn’t given any information about it!

I can’t take a lot of medication because it causes pain in my abdomen. If you can give me information about this condition, I would really appreciate it! — G.M.

The mesentery is a large fold of connective tissue that holds in place the structures of the abdomen. Mesenteric panniculitis is one of a group of related conditions, called “sclerosing mesenteritis.” “Sclerosing” means “rocklike,” in reference to the deposits of fibrous tissue (fibrosis) in the mesentery, and “-itis” always means “inflammation.” You are right that the cause is unknown, but a history of abdominal trauma, especially surgery, is common. There may be an autoimmune component to this condition, as it is common in people with other autoimmune diseases.

Some people have no symptoms, but in those who do, the most common are abdominal pain, fever and weight loss, and diarrhea or constipation. Sometimes inflammation is so severe that the bowel becomes blocked or the flow of urine can become obstructed. Most people with this condition have pretty stable symptoms.

It can be slowly progressive in some people, while a few others resolve over time. Treatment is indicated for people with symptoms, and the usual first treatment is a steroid like prednisone to combat the inflammation. Tamoxifen, which helps inhibit fibrous tissue deposition, often is given at the same time.

I recommend a diet low in pro-inflammatory red meat and high in fruits and vegetables, whole grains, legumes and nuts. Keep a food diary to identify foods that seem to trigger symptoms in you.