Mastocytic Enterocolitis: Symptoms, Causes, Complications, Diagnosis, Treatment, Prevention
One of the conditions that do not get talked about too often is Mastocytic Enterocolitis. But what is it, really? Well, for starters, Mastocytic Enterocolitis is a condition where a person is already suffering from a long-standing kind of diarrhea - the intractable, and chronic kind. This so happens when someone has a biopsied duodenum, or the first part of the small intestine, even if his colon is actually normal.
When mast cells, or the master cell regulators multiply in the colon's innermost layer, there gets to be an imbalance in the digestive and excretory tract, and thus, Mastocytic Enterocolitis begins.
Mast cells are found almost anywhere in the body - the skin, the bladder, joints, lungs, and even in the brain, and the heart. Generally, they are needed by the body to keep a person protected from certain diseases, or parasites, but there are times when the number just doubles or triples - or even worse - and thus, the body cannot keep up with it anymore, and instead of being able to help the body, it actually poses more threats to it including bacteria, viruses, and stress, with diarrhea being the most prominent factor.
Considered as a new disorder that even some doctors all over the world don't even know about, the condition is sometimes confused with Irritable Bowel Syndrome (IBS), and sometimes, constipation. However, it is mostly a worse kind of diarrhea, but not just simple diarrhea, either, and it could happen to just about anyone - and this is why you have to learn more about it.
What are the categories of Mastocytic Enterocolitis?
Apart from having a seemingly unending type of diarrhea, and inflamed gastrointestinal tract, you have to realize that Mastocytic Enterocolitis happens due to a variety of reasons, and this is why it is categorized into a variety of types. These types then begin to depict different symptoms - which will then help you understand how exactly the condition happens. For this, you can check out the table below:
This type of Mastocytic Enterocolitisthat happens when the mast cells have distributed in the bone marrow, and then all over the body. With this comes enlarged liver or spleen, enlarged lymph nodes, bone fractures, diarrhea, unexplained flushing, peptic ulcers, and low blood pressure.
Isolated Mastocytic Enterocolitis
This is one of the hardest types to diagnose, mostly because a biopsy of the intestines have to be done first.
With this one, it means that the skin tissues have been plagued by too many mast cells. With that, you can expect to see eruptions or rashes on the skin.
General Mastocytic Enterocolitis
Apart from diarrhea, this is accompanied with abdominal pain, fever, and then blood on the stool.
What are the causes of Mastocytic Enterocolitis, and who are at risk?
While there is no known main cause of the condition, it's mostly because of the accumulation of mast cells. You see, each of these cells have storage sacs - also known as excretory granules that then contain mediator molecules. Their main use is to go through each of the tissues in the body so they could protect the skin and the connective tissues from being damaged by free radicals. They're also responsible for releasing chemical alarms in the body so that the parts of the immune system that are being damaged would know that something is wrong with them.
Now, that's where the problem begins. Chemical alarms are also known as histamine. If you're familiar with that term, then you probably realize that it's something that some people are allergic to - and that's why anti-histamines are around. Therefore, if the amount of these chemical alarms, masquerading as mast cells, increase in your system, then it may mean that you'd feel some kind of imbalance in the body. Add to that, there could also be an increased amount of inflamed cells. That would mean the gastrointestinal tract would be suffering, and by that point, it would mean that the body would be incredibly sensitive to pain - so the digestive tract gets to be affected.
Risk factors may differ, but as you can see from what was mentioned above, there is a bigger chance that these people would be afflicted with the disease. However, you also have to keep in mind that just because there's a risk factor, it does not necessarily mean that the person would get sick right away, so it is still best not to self-diagnose, but get the opinion of a professional, definitely.
What is the Age and Gender Distribution of this Condition?
Apart from risk factors, it is also best that you get to understand who else could be affected by the disorder. If you may recall, the condition actually starts with diarrhea - the longstanding kind, and this definitely can happen anywhere, with at least 5% of Americans affected on a regular basis. 70% of people around the world, meanwhile, also suffer from diarrhea, and there are no predispositions when it comes to ethnicity, race, or age, especially when one gets to be affected by diarrhea even when the cause is unknown.
Does it Pose Any Complications?
Normal diarrhea already affects the body in a lot of negative ways. Sometimes, it also affects the mind in such a way that the person who is afflicted will definitely get stressed out. After all, it is never a good feeling to have to go to the restroom all the time. Therefore, Mastocytic Enterocolitis also has such a negative effect on one's quality of life.
For example, if a person is afflicted with this condition, chances are, he would rather stay at home rather than go to work or school because of the embarrassment of having to go to the restroom all the time. Because of this, there might be missed work or school days, and of course, that affects the productivity of the person involved. It is also quite excruciating for the body to go through this - there is going to be a lot of water loss. The fact that the body would also be suffering from hives, and lesions, muscle pain, and nausea, among others, is also debilitating. So, while it seems to be “trivial” at first, it definitely is a serious condition - one that shouldn't really be taken lightly.
Those with Rheumatoid Arthritis, Inflammatory Conditions, and Auto-Immune Disorders are most at risk of getting afflicted with Mastocytic Enterocolitis.
How is the Condition Diagnosed?
In order to know that you are afflicted with Mastocytic Enterocolitis, it has to be diagnosed first. How does this happen, then?
Well, for one, there is the use of endoscopy. If you are not familiar with this, it is a diagnostic method using a flexible, medically-approved tube to look inside the body, exactly to see if there is anything wrong with it. This tube is called an endoscope. Now, apart from the endoscope, some minute instruments are attached to it so that samples of abnormal tissues could be taken; check a certain part of the body more closely; stop bleeding; remove some tumors or foreign bodies; and eventually, to treat the disorder.
A small cut is made so that the endoscope could be inserted inside the human body. It would then be able to check the linings of the esophagus, the tip of the small intestine, which, as aforementioned, is the part that often gets affected by the disorder, and the stomach, as a whole. The colon and rectum are also checked, together with the lowest part of the colon, or the anus, in other words. Of course, the procedure might cause some pain and discomfort, but those are necessary so you would know if there is actually something wrong with you or not.
After the endoscopy, a biopsy is done to check what's inside the person. Just for review, biopsy is about taking residues, stones, or anything inside the body that would help doctors determine what is wrong with the patient. As for this condition, the biopsy should be able to show the amount of inflamed cells that are inside the body, which would mostly be taken from the upper gastrointestinal tract. Flow Cymetry or c-KIT is the technique used to understand what the biopsy means.
Basically, Flow Cymetry is a technique done to check for the chemical and physical characteristics of the fluid particles that have been found, since they would be labeled with fluorescent markers. It mainly checks for how something has been engineered with protein, and if there are excess histamines around, as well. Meanwhile, c-KIT is a molecular technique that checks for the amount of mast cells in the body - helping the doctor understand the kind of Mastocytic Enterocolitis that a person is affected with.
Apart from what was given, other techniques may also be used by the doctor or the healthcare provider to understand the condition even better, one of which is a skin of bone marrow biopsy. If you may recall, it was mentioned earlier that mast cells may be propagated from the bone marrow, and that they are dispersed through the skin, so it is important to determine if the number is already too big - and to see if there are other problems in these parts of the body, too. Another one is to check for serum or urine histamine levels - which is one of the easiest ways to see if the amount of histamine in one's body is too much, and if histamine is affecting this person in a way that's far from positive. Then, of course, serum tryptase could also be done. It is also a way of checking for histamine, together with other allergens that may be debilitating to the body.
If the level of tryptase happens to be over 11.5 ng/mL, it means that something is wrong, and that allergen challenges or anaphylaxis - two things that are extremely terrible for the body - may happen, or are already happening. When tryptase level is not right, the immune system would not be able to protect the body the way it should. It also causes extreme hypersensitivity, and this is why the body reacts in such a way that it tries to push down all the elements that it feels are unnatural - for example, through diarrhea. This is exactly why the condition is actually alarming. It is definitely more than just having a “bad stomach” - it is more than just normal diarrhea.
When the medical provider feels like enough tests have already been done, he may then decide to rule out other procedures, such as imaging modalities, providing dietary modifications, or getting stool cultures.
Sure enough, the diagnosis seems to be complicated. However, if you would not see a doctor, and would not want to get a proper diagnosis, then chances are, the condition might worsen - and that's not really something you want to happen, especially now that you are familiar with how it can complicate one's life.
How is it Treated? What could be Done?
When one is already diagnosed with Mastocytic Enterocolitis, the next thing that one should think about is what exactly could be done to help alleviate the condition. If you get afflicted, how will you be treated? What's supposed to happen?
Here's what you have to keep in mind: Compared to other diseases, there is not enough information about the whole process of treatment for the condition - and that's exactly why it's one of those ailments that don't often get talked about, and that most people are still confused about. However, one thing that can initially be done is to take anti-histamines, more commonly known as anti-allergy medications. These medications can help stabilize and bring into balance the intense number of mast cells in one's body. Examples of the medication include Famotidine, which is mostly used to treat ulcers, whether in the mouth or in the stomach; Ranitidine, which, aside from treating ulcers, is also responsible for the treatment of acid-related damages in the body, and might prevent the prognosis of the condition; Cetirizine, which is used to treat sneezing and cold allergies, together with runny nose, watery eyes, or itching related to being exposed to certain allergens, and; Desloratadine, or a medication that's originally used to treat hives, watery eyes, and hay fever.
Apart from using anti-histamines, it might also be helpful if the afflicted person would avoid certain triggers, such as Ibuprofen, or other non-steroidal drugs, as well as alcohol - because these might do more damage to one's body than good.
Going back to its roots - which is diarrhea, of course - it's best that you stay hydrated, if ever you get afflicted, and even not. You see, when the body tries to excrete a lot of things at any given time, it gets rid of the right amount of water that keeps it healthy. It is best to drink water, and then stay away from coffee or tea - or any other beverages that contain caffeine, and alcohol. It would also be good to eat a healthy diet, one that consists of protein, fruits, and vegetables.
Certain foods are also recommended to those who suffer from diarrhea, which might also work for those who are suffering from Mastocytic Enterocolitis. These include baked chicken - excluding skin and fat; pretzels; plain crackers; toast, and; boiled potatoes. Some choose to drink Loperamide, an over-the-counter medication that's suited for treating diarrhea, but since this is a worsened condition, it's advisable that you check with your doctor first.
Then, you should definitely try to avoid eating fatty foods, especially those with too much oil or gravy as they could worsen your condition. Apart from that, it's also best not to eat cheese, milk, ice cream, butter, or any form of dairy as these interact with the stomach in a negative way, especially if you already have some form of lactose-intolerance, to begin with. Artificial sweeteners such as Sorbitol should also be avoided, as these contain ingredients that would not really improve the condition of someone suffering from any form of diarrhea or mastocytis - if you have a sweet tooth, or are craving for something sweet, just try diet soft drinks, or sugarless gum or candy, instead. Or, look for Paleo or Gluten-free alternatives - so you can still enjoy while keeping your health in check.
Tainted foods, or those food products that may have been packed, or could be mishandled in any way, also have to be avoided. These include raw meat or fish, or anything frozen that you have bought from the grocery. And of course, you also have to avoid gassy foods - or foods that worsen gas in the body, such as cauliflower, cabbage, broccoli, or beans. You do not necessarily have to avoid them forever - just when you're suffering from digestive problems, and just until you get better, of course.
Can this Problem be Prevented?
As of this writing, there are no known foolproof ways of preventing mastocytis yet. However, there are certain personal steps you can take to help you ensure your safety. For one, you can try switching to a healthier lifestyle - try to eat a healthy and balanced diet, exercise regularly, drink enough water, and get enough sleep. Because, seriously, no matter who you are or whatever it is that you are doing in life, nothing still beats living a healthy lifestyle, and giving yourself your best chance at life.
Then, if you find yourself not feeling well, and you realize that you may be experiencing the symptoms that have been given earlier, then, it's best that you try to see a doctor right away. You might feel like you already know what's happening, but without proper diagnosis, the problem might just get worse - and that's surely what you wouldn't want to happen. If you feel like the doctors in your place don't specialize in digestive disorders, or don't have the right equipment that can help with the diagnosis, don't be afraid to check with someone else. You won't be wasting money if you're trying to know things that would be good for your health, because your health really is the best thing you have, and without it, you won't be able to do anything else. See a specialist, because if you don't, you will be surprised at how much you may need to spend after - so it's best to treat it while it's new, and when the right things can still be done.
Apart from living a healthy lifestyle and getting proper diagnosis, you might also want to join support groups regarding the condition. While it's not proverbially known by everyone yet, there are actually people who are suffering from this condition - and they are open for those who also need help regarding it.
You may think it's cheesy, but joining such group would help you understand what's going on, and help you realize that you are not alone in the struggle, especially with a disease as new as this. These groups are non-profit, and if you are lucky, you might even find one near your area - so maybe, you can join meet-ups, or activities that will help you get by, provide you with awareness about the condition, help you understand what you could do to help yourself even more, and just provide you with the mental and emotional support that you need - because more than anything, this is what people need best.
Once you are able to join one of those groups, you would feel less confused about your condition, and with the help of others like you, you would get to learn more about it, including what you need to avoid, what you have to do, and you will also be provided with the right research materials, and all other important resources that you need. There are also groups with medical advisors as members - so you can be sure that you get the right information that you need, and in time, you just might be able to help others, too.
By learning more about Mastocytic Enterocolitis, you can be sure that you'd be able to help yourself - and get to help others, too.