New mast cell/GI disease article

[jme22]

Hello all,

My gastro co-authored an article on the role of mast cells in gastrointestinal disease that was published this month. I know from our discussions that he is committed to getting the word out to his fellow physicians about the importance of considering mast cell involvement when evaluating patients with chronic GI complaints. If it weren't for his interest and firm belief in the role of mast cells and GI problems, I probably would still be carrying a diagnosis of IBS, rather than ME. As I have told him many times, it was like divine intervention for me to end up in his practice.

I wanted to share the article as I'm a firm believer in the "knowledge is power" philosophy. However, this is definitely not "light reading" as it is written by doctors, for doctors. But, perhaps it is something that could be shared with a physician who is not familiar with the role of mast cells and GI issues. Maybe the article could start a conversation between a patient and a doctor that would ultimately lead to a diagnosis. Wouldn't that be great?!

Here's the link:

http://www.clinicaladvances.com/article ... ramsay.pdf

Let me know what you think,

Julie

[Joefnh]

Hi Julie, that's an excellent article, very well written and presented. I thought the research and conclusions were well supported and documented. You certainly are fortunate to have this doctor.

Thanks for posting this I have been asking questions about this topic to Mary Beth in a recent meeting in Boston.

Thanks Again Julie

--Joe

[mbeezie]

Julie,

Thanks for posting. This is a great article to share with GIs to help get them up to speed. I was glad to see that the authors at least mention Type IV hypersensitivty reactions to food. It is my belief that Type IV reactions are what we are experiencing and why MRT helps to identify trigger foods.

Mary Beth

[Polly]

Julie, thanks so much for posting this article. I found it quite interesting, and it has renewed my faith in the GI community (well, a little, anyway).

I was particularly interested to see the mind-body connection highlighted. The fact that the nerves in the gut are situated next to the mast cells and can "set them off" during stress is an important finding to me, since I believe I had a serious, stress-induced flare recently. Also, I liked the way credence was given to "intestinal permeability" - of course, they didn't use the term "leaky gut" but they described it perfectly.

Mary Beth, why do you suppose they didn't recommend MRT? They do mention trying food elimination as a way of determining problem foods, but they stopped short of recommending MRT.

Thanks again. Julie, is your GI in D.C.? I live next door in MD. I am increasingly starting to think I have a mast cell problem - probably a "leaker" as described by Mary Beth.

Hugs,

Polly

[Gloria]

Thanks for posting the article, Julie. It would be an excellent primer for our GI's. They should be doing a stain for mast cells when they do a colonoscopy for patients presenting with D and/or constipation.

I haven't taken any H1 or H2 antihistamines, and seem to be able to control my symptoms using diet. However, I have had to eliminate many, many foods. Haven't we discovered problems from using H1 and H2 antihistamines? I've been very reluctant to take them.

Gloria

[mbeezie]

Polly,

I think many in the medical community are still skeptical of MRT but that seems to be changing. Sometimes I also think they confuse it with Alcat or IgG testing, which is not the same.

I was thinking of you and a potential mast cell problem this morning as I read grannyh's post on colonoscopies triggering MC flares. I had a bad mast cell reaction to MoviPrep and have read about mast cell patients not tolerating PEG well. There may be a connection.

Gloria,

I never took H2 but do take Claritin (H1) prn. Diet seems to work best for me too.

Mary Beth

[Polly]

Hi Mary Beth!

Bingo! It hadn't even occurred to me, but my flare this summer started after my colonscopy. I took PEG (Miralax) this time. I can't remember the exact timing of the flare, but maybe there is an association. The colonoscopy was July 2, and my dog died Aug. 26th. However, I was having increasing GI problems throughout that period, which I attributed to worry about my dog and knowing the end was near. Maybe it was the PEG and not solely the stress??? Would the reaction be immediate, do you think, or could it develop over time? When the GI doc gave me the colon photos that day, I remember thinking how "inflamed" the mucosa looked throughout - kind of an angry, almost blistery-looking red. (The biopsies were negative for MC, but maybe the PEG irritated my gut that day and started the flare).

Hugs,

Polly

[tex]

I remember thinking how "inflamed" the mucosa looked throughout - kind of an angry, almost blistery-looking red.

Wow! That sounds like a "smoking gun" to me. And the fact that MC markers were still absent, sure points the finger at the colonoscopy prep. I would think that the enteritis comes first, and the MC comes later, (IMO, MC is the result of a chronic inflammation situation, rather then inflammation being the result of MC - that is, MC is a symptom of inflammation, rather than inflammation being a symptom of MC). Am I right?

Tex

[Polly]

Tex,

I seem to be chasing you around the Board! LOL! I think you are EXACTLY right..... and hit the nail squarely on the head.

Love,

Polly

[tex]

I seem to be chasing you around the Board!

It seems to me that you're always one step ahead of me, though.

Love,
Tex

[mbeezie]

Polly,

For me the reaction was immediate, but I am a shocker, not a leaker. I am guessing it's possible that your symptoms started to develop from the prep and then got exacerbated by stress. As Dr. Castells pointed out to me in my visit, once mast cells are activated they can stay activated for a period of time and symptoms can wax and wane before fully resolving. Have you had any other unusual symptoms besides D?

Mary Beth