Mesenteric Panniculitis or Sclerosing Mesenteritis

Posted by BillyMac65 @billymac65, Dec 6, 2012

I thought I would start a discussion for patients with Mesenteric Panniculitis. From what I know, this auto-immune disorder has three stages to it, each with differing names (Mesenteric Panniculitis, Schlerosing Mesenteritis, Retractile Mesenteritis). Typically, this appears to be in older individuals with some other under-lying problem (Lymphoma, tumor, diverticulitis).

I have an atypical presentation because I do not have an underlying cause. The doctors seem to be hoping for Lymphoma to appear so they can treat it and have the auto-immune go away. I am interested in hearing from others with this. I had this diagnosed in 2011, so I am interested in hearing more about what this is like to live with. I want to hear from others who also have an atypical presentation. Did is come back? Also interested in hearing from those with Lymphoma. How was the treatment? Did it address the auto-immune?

Pretty much, I am interested in hearing from anyone who has had this, so i can better understand it, and not feel so alone with this!!

Bill

Back Atcha!!!! Happy New Year!!

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@tarad

First of all, MANY thanks to @vdouglas, for finding my original post in the auto immune forum here on TMC connect site. I’m so relieved (as morbid as that is to say) to see that I really am NOT alone…. I’ll preface by saying there is a very real possibility I may rely heavily on everyone’s experiences through this in this forum.

I feel like I’m slowly going crazy… I had a hysterectomy May 9, 2017. By August, I was diagnosed with mesenteric panniculitis that was “accidentally discovered” when I continued having abdominal pain after surgery (my gyno naturally thought it was my ovaries; CT scans done and radiologist found the MP). I was sent to a surgical oncologist that was said to be a “GI guru” and have extensive knowledge in all things “weird and rare”. He was rather dismissive about it all as, based on my lab work my gyno had done, there was nothing that made him think there was a concern for cancer. Just brushed it off as an “annoyance issue”, that the pain could stay for a month or a year, but he would give me Mobic to help with the inflammation and it should eventually resolve itself (standard treatment for MP is through steroids, but I have anaphylactic reactions to all steroids, and I’m kinda trying to NOT die….). I’m a month in on the Mobic, the flare ups in pain are more frequent with the pain being more and more intense. Nausea has also started to set up and my appetite is waning, at best, as most of the time, the thought of food makes me sick. My PCP and gyno weren’t pleased with the consult I had from oncol. One has ordered a repeat CT to be done in a couple of months to monitor progression/improvement. The other has referred me to gastro and hematology. I had a positive ANA and a positive double strand DNA. My spleen has been consistently mildly enlarged on the past few CT’s I’ve had done. Research material on this is limited. I feel like I’m in a snowglobe, being shaken up with all these doctors, throwing around words like “necrosis” and “restricted blood flow” and “cancer” and referral after referral. I’m frustrated and tired of “hurry up and wait”….

What’s your insight on what I’m looking at long term?? I’ve never had anything chronically, so I’m lost on what to expect. My PCP is very literally clueless. The “GI guru” has, in effect, blown me off – I called seeking helping when the Mobic failed to work. All I’ve gotten was a text message from the pharmacy saying my Rx was ready (apparently, he just called in something new without talking with me about what I had going on). Today, I got a call from his office saying they were going to refer me to a gastro but saw that I was already scheduled and wished me best of luck. Still have not spoken to him. Glad my intestinal tract hasn’t shriveled up and fallen out waiting for him to get back with me (sarcasm).

Hit me with whatever info you’ve got. Books. Articles. Suggestions on diet modifications. Meds you’ve tried that were successful. Anyone tried anything holistically? I am desperately wanting to “get in front of the ball” as best I can – the bad days are BAD. I have two kids to raise, one 16 and one 6. Mommy doesn’t have time for debilitating…..

Bless every one of you all!!!!!!! Sending everyone lots of hugs and support from Kentucky!!!!!!

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Hi Von, thank you for your response. I have decided to be proactive an make an appointment at the Mayo. I was wondering….when you went, were you there for more than the day? What did your bring with you for your appointment? Did they do further testing and if so, how long did it take to go over the results with you? Did they give you a course of treatment? I would have to fly in from Rhode Island and didn’t know how long to plan my stay for.
Thanks,
Cindy Connors

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@tarad

First of all, MANY thanks to @vdouglas, for finding my original post in the auto immune forum here on TMC connect site. I’m so relieved (as morbid as that is to say) to see that I really am NOT alone…. I’ll preface by saying there is a very real possibility I may rely heavily on everyone’s experiences through this in this forum.

I feel like I’m slowly going crazy… I had a hysterectomy May 9, 2017. By August, I was diagnosed with mesenteric panniculitis that was “accidentally discovered” when I continued having abdominal pain after surgery (my gyno naturally thought it was my ovaries; CT scans done and radiologist found the MP). I was sent to a surgical oncologist that was said to be a “GI guru” and have extensive knowledge in all things “weird and rare”. He was rather dismissive about it all as, based on my lab work my gyno had done, there was nothing that made him think there was a concern for cancer. Just brushed it off as an “annoyance issue”, that the pain could stay for a month or a year, but he would give me Mobic to help with the inflammation and it should eventually resolve itself (standard treatment for MP is through steroids, but I have anaphylactic reactions to all steroids, and I’m kinda trying to NOT die….). I’m a month in on the Mobic, the flare ups in pain are more frequent with the pain being more and more intense. Nausea has also started to set up and my appetite is waning, at best, as most of the time, the thought of food makes me sick. My PCP and gyno weren’t pleased with the consult I had from oncol. One has ordered a repeat CT to be done in a couple of months to monitor progression/improvement. The other has referred me to gastro and hematology. I had a positive ANA and a positive double strand DNA. My spleen has been consistently mildly enlarged on the past few CT’s I’ve had done. Research material on this is limited. I feel like I’m in a snowglobe, being shaken up with all these doctors, throwing around words like “necrosis” and “restricted blood flow” and “cancer” and referral after referral. I’m frustrated and tired of “hurry up and wait”….

What’s your insight on what I’m looking at long term?? I’ve never had anything chronically, so I’m lost on what to expect. My PCP is very literally clueless. The “GI guru” has, in effect, blown me off – I called seeking helping when the Mobic failed to work. All I’ve gotten was a text message from the pharmacy saying my Rx was ready (apparently, he just called in something new without talking with me about what I had going on). Today, I got a call from his office saying they were going to refer me to a gastro but saw that I was already scheduled and wished me best of luck. Still have not spoken to him. Glad my intestinal tract hasn’t shriveled up and fallen out waiting for him to get back with me (sarcasm).

Hit me with whatever info you’ve got. Books. Articles. Suggestions on diet modifications. Meds you’ve tried that were successful. Anyone tried anything holistically? I am desperately wanting to “get in front of the ball” as best I can – the bad days are BAD. I have two kids to raise, one 16 and one 6. Mommy doesn’t have time for debilitating…..

Bless every one of you all!!!!!!! Sending everyone lots of hugs and support from Kentucky!!!!!!

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Hi @cconnors,

Your question about appointment scheduling/travel is one that many of our members can identify with. We have some fantastic discussions in the Visiting Mayo Clinic group on Connect which you may wish to view: https://connect.mayoclinic.org/group/traveling-to-mayo-clinic-minnesota/

Another good source of information is Mayo Clinic’s Concierge Service. It is a free service provided by Mayo Clinic for patients.
You can contact @clockrem12, at Concierge Services. They are open Monday-Friday, 8 a.m.-6 p.m. and can be reached by phone and email at 507-538-8438 or concierge@mayo.edu
We wish you all success.

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Hi all, since some questions arose on this thread regarding prednisone and prednisolone, we asked a Mayo Clinic pharmacist if she might have anything to add to the discussion. Here what she had to say:

Prednisone and prednisolone are steroids that can reduce inflammation from a large variety of conditions. Both are available in tablet and liquid formulations. The expected side effects would be the same. The liquid formulations are best for children and patients who have difficulty swallowing pills. The liquid formulation gets into our blood a little faster than tablets. Nausea with both formulations can be reduced taking doses with some bland food.

Additional tips for managing steroid-related side effects can be found at https://www.hss.edu/conditions_steroid-side-effects-how-to-reduce-corticosteroid-side-effects.asp.

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@lisalucier

Hi all, since some questions arose on this thread regarding prednisone and prednisolone, we asked a Mayo Clinic pharmacist if she might have anything to add to the discussion. Here what she had to say:

Prednisone and prednisolone are steroids that can reduce inflammation from a large variety of conditions. Both are available in tablet and liquid formulations. The expected side effects would be the same. The liquid formulations are best for children and patients who have difficulty swallowing pills. The liquid formulation gets into our blood a little faster than tablets. Nausea with both formulations can be reduced taking doses with some bland food.

Additional tips for managing steroid-related side effects can be found at https://www.hss.edu/conditions_steroid-side-effects-how-to-reduce-corticosteroid-side-effects.asp.

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Thank you for this Lisa!

Liked by Lisa Lucier

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@k2aunt

I came across this posting while doing a search and decided to join because it looks useful to me. I was diagnosed with mesenteric panniculitis on February 20 of this year after going to the emergency room in extreme pain and not being able to keep any food or liquid down. I was brought back to the rapid response room from triage because of a high heart rate which i wasn’t having any chest pains at all and the e.r. doc sent me for a CT Scan which showed the mesenteric panniculitis. i was told the pain could last from 12 to 18 months which is not fun. I was put on levaquin and flagyl and told to follow-up with a g.i. doc which i did with an associate of my regular g.i. doc.. She ran some blood work and put on me on another set of meds which worked for a bit then the pain came back again. Got a chance to talk to my regular g.i. doc when accompanyming my husband on his follow-up visit and mentioned that i was diagnosed with this. I was told if i am still having issues to let him know after my husband’s endoscopy which i did and was prescribed another med which helped for a bit then stopped worked like the other meds i had been on. While waiting for my husband to come out of surgery for a muscle biopsy i received a call from my g.i. doc after leaving a message to let him know that the pain came back full force a couple of days prior with nothing helping. He had me go under another endoscopy which didn’t show anything to the naked eye since he couldn’t do a biopsy since I am currently on coumadin and didn’t come off since this was somewhat an emergency. I was put on 3 new meds at the time which somewhat helped and like before didn’t last very long helping the pain. Saw him for my follow-up last monday and put on another med along sending me for another set of x-rays that showed the area that does not show up with a colonoscopy and endoscopy which those came back normal. My doc is now stumped on what to do to help control the pain so he is at the point he is sending me to either Johns Hopkins or Medstar Georgetown Hospital for further evaluation. I don’t mind dealing with pain but if i get a “flare-up” it hurts to the point i can’t do anything. Thanks for listening and any suggestions you might be able to provide.

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I was first diagnosed with this disease in 2002, since the this doctor passed away. My MD has been supportive but lacks the knowledge a specialist might have. Although she has referred me to several who don’t even care to discuss or understand this disease.
Since turning 65 last spring the pain is almost unbearable. I don’t know what to do or where to turn.

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@k2aunt

I came across this posting while doing a search and decided to join because it looks useful to me. I was diagnosed with mesenteric panniculitis on February 20 of this year after going to the emergency room in extreme pain and not being able to keep any food or liquid down. I was brought back to the rapid response room from triage because of a high heart rate which i wasn’t having any chest pains at all and the e.r. doc sent me for a CT Scan which showed the mesenteric panniculitis. i was told the pain could last from 12 to 18 months which is not fun. I was put on levaquin and flagyl and told to follow-up with a g.i. doc which i did with an associate of my regular g.i. doc.. She ran some blood work and put on me on another set of meds which worked for a bit then the pain came back again. Got a chance to talk to my regular g.i. doc when accompanyming my husband on his follow-up visit and mentioned that i was diagnosed with this. I was told if i am still having issues to let him know after my husband’s endoscopy which i did and was prescribed another med which helped for a bit then stopped worked like the other meds i had been on. While waiting for my husband to come out of surgery for a muscle biopsy i received a call from my g.i. doc after leaving a message to let him know that the pain came back full force a couple of days prior with nothing helping. He had me go under another endoscopy which didn’t show anything to the naked eye since he couldn’t do a biopsy since I am currently on coumadin and didn’t come off since this was somewhat an emergency. I was put on 3 new meds at the time which somewhat helped and like before didn’t last very long helping the pain. Saw him for my follow-up last monday and put on another med along sending me for another set of x-rays that showed the area that does not show up with a colonoscopy and endoscopy which those came back normal. My doc is now stumped on what to do to help control the pain so he is at the point he is sending me to either Johns Hopkins or Medstar Georgetown Hospital for further evaluation. I don’t mind dealing with pain but if i get a “flare-up” it hurts to the point i can’t do anything. Thanks for listening and any suggestions you might be able to provide.

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I would like to add that what got me through the bad spells over the years was a micro current machine through a Natuapathic Doctor, who gave me a prescription for my own…

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@k2aunt

I came across this posting while doing a search and decided to join because it looks useful to me. I was diagnosed with mesenteric panniculitis on February 20 of this year after going to the emergency room in extreme pain and not being able to keep any food or liquid down. I was brought back to the rapid response room from triage because of a high heart rate which i wasn’t having any chest pains at all and the e.r. doc sent me for a CT Scan which showed the mesenteric panniculitis. i was told the pain could last from 12 to 18 months which is not fun. I was put on levaquin and flagyl and told to follow-up with a g.i. doc which i did with an associate of my regular g.i. doc.. She ran some blood work and put on me on another set of meds which worked for a bit then the pain came back again. Got a chance to talk to my regular g.i. doc when accompanyming my husband on his follow-up visit and mentioned that i was diagnosed with this. I was told if i am still having issues to let him know after my husband’s endoscopy which i did and was prescribed another med which helped for a bit then stopped worked like the other meds i had been on. While waiting for my husband to come out of surgery for a muscle biopsy i received a call from my g.i. doc after leaving a message to let him know that the pain came back full force a couple of days prior with nothing helping. He had me go under another endoscopy which didn’t show anything to the naked eye since he couldn’t do a biopsy since I am currently on coumadin and didn’t come off since this was somewhat an emergency. I was put on 3 new meds at the time which somewhat helped and like before didn’t last very long helping the pain. Saw him for my follow-up last monday and put on another med along sending me for another set of x-rays that showed the area that does not show up with a colonoscopy and endoscopy which those came back normal. My doc is now stumped on what to do to help control the pain so he is at the point he is sending me to either Johns Hopkins or Medstar Georgetown Hospital for further evaluation. I don’t mind dealing with pain but if i get a “flare-up” it hurts to the point i can’t do anything. Thanks for listening and any suggestions you might be able to provide.

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Actually I am going to a naturopath on Monday and was wondering what a micro current machine is….

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Morning @pacemonie. It is difficult to find a Doctor who is into this rare disease. What area of what country do you live in? Maybe someone can help direct you. We all have had different experiences but know this pain for sure. Sending good thoughts!

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I live in Vancouver, WA which is just a few miles from Portland, OR…I would appreciate any ideas on Doctors out this way. I am wondering if an anti inflammatory diet may help? I am at a point where I can’t take anymore pain. I had a pain shot yesterday that didn’t give me much relief.

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@k2aunt

I came across this posting while doing a search and decided to join because it looks useful to me. I was diagnosed with mesenteric panniculitis on February 20 of this year after going to the emergency room in extreme pain and not being able to keep any food or liquid down. I was brought back to the rapid response room from triage because of a high heart rate which i wasn’t having any chest pains at all and the e.r. doc sent me for a CT Scan which showed the mesenteric panniculitis. i was told the pain could last from 12 to 18 months which is not fun. I was put on levaquin and flagyl and told to follow-up with a g.i. doc which i did with an associate of my regular g.i. doc.. She ran some blood work and put on me on another set of meds which worked for a bit then the pain came back again. Got a chance to talk to my regular g.i. doc when accompanyming my husband on his follow-up visit and mentioned that i was diagnosed with this. I was told if i am still having issues to let him know after my husband’s endoscopy which i did and was prescribed another med which helped for a bit then stopped worked like the other meds i had been on. While waiting for my husband to come out of surgery for a muscle biopsy i received a call from my g.i. doc after leaving a message to let him know that the pain came back full force a couple of days prior with nothing helping. He had me go under another endoscopy which didn’t show anything to the naked eye since he couldn’t do a biopsy since I am currently on coumadin and didn’t come off since this was somewhat an emergency. I was put on 3 new meds at the time which somewhat helped and like before didn’t last very long helping the pain. Saw him for my follow-up last monday and put on another med along sending me for another set of x-rays that showed the area that does not show up with a colonoscopy and endoscopy which those came back normal. My doc is now stumped on what to do to help control the pain so he is at the point he is sending me to either Johns Hopkins or Medstar Georgetown Hospital for further evaluation. I don’t mind dealing with pain but if i get a “flare-up” it hurts to the point i can’t do anything. Thanks for listening and any suggestions you might be able to provide.

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My naturopathic doctor suggested the Inspirstar, which she programmed…it just has 4 electrodes I place near the pain and run it through its cycle. It did take a prescription to get that type.

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@k2aunt

I came across this posting while doing a search and decided to join because it looks useful to me. I was diagnosed with mesenteric panniculitis on February 20 of this year after going to the emergency room in extreme pain and not being able to keep any food or liquid down. I was brought back to the rapid response room from triage because of a high heart rate which i wasn’t having any chest pains at all and the e.r. doc sent me for a CT Scan which showed the mesenteric panniculitis. i was told the pain could last from 12 to 18 months which is not fun. I was put on levaquin and flagyl and told to follow-up with a g.i. doc which i did with an associate of my regular g.i. doc.. She ran some blood work and put on me on another set of meds which worked for a bit then the pain came back again. Got a chance to talk to my regular g.i. doc when accompanyming my husband on his follow-up visit and mentioned that i was diagnosed with this. I was told if i am still having issues to let him know after my husband’s endoscopy which i did and was prescribed another med which helped for a bit then stopped worked like the other meds i had been on. While waiting for my husband to come out of surgery for a muscle biopsy i received a call from my g.i. doc after leaving a message to let him know that the pain came back full force a couple of days prior with nothing helping. He had me go under another endoscopy which didn’t show anything to the naked eye since he couldn’t do a biopsy since I am currently on coumadin and didn’t come off since this was somewhat an emergency. I was put on 3 new meds at the time which somewhat helped and like before didn’t last very long helping the pain. Saw him for my follow-up last monday and put on another med along sending me for another set of x-rays that showed the area that does not show up with a colonoscopy and endoscopy which those came back normal. My doc is now stumped on what to do to help control the pain so he is at the point he is sending me to either Johns Hopkins or Medstar Georgetown Hospital for further evaluation. I don’t mind dealing with pain but if i get a “flare-up” it hurts to the point i can’t do anything. Thanks for listening and any suggestions you might be able to provide.

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Thanks! I will update everyone after Monday regarding my appointment with the naturopath. Tonight, I am going to try to take a sauna. I have read that sauna heat helps reduce inflammation. I have also heard the same about Brazilian nuts….

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Hello @pacemonie
Sorry to hear you are dealing with the pain associated with MP. As far as doctors go the best for diagnosis and prognosis are at the Mayo Clinic in Rochester Mn. The reason I say this is because they know what they are looking at on a CT scan. Most doctors will only see the haziness or mass and not know what they are looking at. Most doctors will not know how far the disease has progressed. The Mayo Clinic Gastroenterology team will know how to interpret the CT and be able to recommend the best treatment. I say this based upon my personal experience.

That being said, once diagnosed typically you would be started on prednisone to help with the inflammation which will subsequently relieve the pain. If the pain is manageable it’s quite possible just mild pain medication would help. If you were seeing a “helpful Gastroenterologist”, meaning one that is willing to study the disease and treatment, this is the treatment most likely to occur.

We know what you are going through and wish you the best.
@vdouglas

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@billindc

Looking for the best place to seek treatment for mesenteric panniculitis in the DC or Baltimore area. Recently diagnosed after 3 abdominal CTs in the last 10 months and ER trips due to nausea and abdominal pain and bloating. My primary doc is at a loss, local GI docs tell me they have only read about the disorder. Need a more experienced doctor. Thanks for any help. Once I stopped my prednisone, symptoms returned. I also have ankylosing spondylitis and had gallbladder removed years ago. Has anyone also had headache and dizziness/light-headedness with this? So glad to find this group, thanks. ~Bill

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Hello, I was diagnosed with MP in 2015 and having some very bad affects from post acute MP. I’m 54yo male in New Hampshire that is having a very poor time finding any medical professionals that know how to treat.

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I’m a 54yo male diagnosed with MP in 2015 and 2016, with health problems post acute MP. I live in NH. Having hard time finding medical professionals who know how to treat MP. I’m current condition is in a weaken state with poor B12 and iron. Unable to raise either by supplements which cause severe bloating and pain or diet. It’s taking a toll on a normal life.

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