- Location
- Washington, DC
I'm just wondering. After loads and loads of tests and no real answers to why I bleed more often than not with BMs, a few months ago, it occurred to me to ask my GI doctor if the fact that I sometimes broke out in inexplicable hives before diarrhea attacks and had episodes of flushing was significant.
Turns out, it *is* significant -- enough to run tests to rule out carcinoid syndrome, pheochromocytoma, and a handful of others. Fortunately, I don't have any of these things going on.
But I saw a specialist last week for some other issues I've been dealing with, and he determined pretty fast that I probably have a problem with mast cells -- either too many of them or erratic and excessive activations of the the ones I have.
He put me on a combo of Zantac and Claritin, two histimine antagonists that work with different mechanisms, to help with my skin problems. He said there'd be a strong chance some of my GI issues would clear up too. Sure enough, while my gut is still kind of a mess, it's better than it's been in a while. The reddish-purple welts I had all over my legs have completely vanished in under a week, and I don't get nearly as itchy at random anymore.
Anyway, I've got some GI follow-up for a bunch of venous malformations in my small intestine, and this new doc said that since they'll have to do an upper and lower scope to cauterize the veins anyway, I should ask for a biopsy and stain for mastocytic enterocolitis.
It's all got me wondering ... it seems mast cell issues are fairly common. Given the fact that they're common, why hasn't a single one of the four GI docs I've seen even mentioned them? I mean, I've even had scopes with obvious inflammation that biopsied normal -- but no one stained for mast cells at the time.
Ok. This was partly just a vent, but I'm genuinely curious -- anyone know why mast cell problems so rarely enter the gastroenterology differential diagnosis for people with intestinal inflammation without an obvious cause?
Turns out, it *is* significant -- enough to run tests to rule out carcinoid syndrome, pheochromocytoma, and a handful of others. Fortunately, I don't have any of these things going on.
But I saw a specialist last week for some other issues I've been dealing with, and he determined pretty fast that I probably have a problem with mast cells -- either too many of them or erratic and excessive activations of the the ones I have.
He put me on a combo of Zantac and Claritin, two histimine antagonists that work with different mechanisms, to help with my skin problems. He said there'd be a strong chance some of my GI issues would clear up too. Sure enough, while my gut is still kind of a mess, it's better than it's been in a while. The reddish-purple welts I had all over my legs have completely vanished in under a week, and I don't get nearly as itchy at random anymore.
Anyway, I've got some GI follow-up for a bunch of venous malformations in my small intestine, and this new doc said that since they'll have to do an upper and lower scope to cauterize the veins anyway, I should ask for a biopsy and stain for mastocytic enterocolitis.
It's all got me wondering ... it seems mast cell issues are fairly common. Given the fact that they're common, why hasn't a single one of the four GI docs I've seen even mentioned them? I mean, I've even had scopes with obvious inflammation that biopsied normal -- but no one stained for mast cells at the time.
Ok. This was partly just a vent, but I'm genuinely curious -- anyone know why mast cell problems so rarely enter the gastroenterology differential diagnosis for people with intestinal inflammation without an obvious cause?
