Mesenteric Panniculitis: Diet, Treatment, Symptoms & What It Is (2023)


What is mesenteric panniculitis?

Mesenteric panniculitis is a rare disorder affecting the mesentery, a connective tissue structure in the back of your abdominal cavity. The mesentery contains the blood supply to your intestines. It’s part of your peritoneum, the tissue that lines your abdominal cavity and covers the organs inside. The mesentery is made up of folds of peritoneum with adipose tissue (body fat) in between.

Mesenteric panniculitis affects the adipose (body fat) tissue layer in the mesentery. It causes chronic inflammation, which causes the fat cells to degrade and die (fat necrosis). Over time, it causes fibrosis (scarring) of the tissues. The inflammation in mesenteric panniculitis is idiopathic, which means it appears to happen spontaneously, without any of the usual causes like infection, injury or cancer.

What is the difference between mesenteric panniculitis and sclerosing mesenteritis?

This is a subject of some debate. Most believe that the two conditions are the same. Some have suggested that sclerosing mesenteritis is a more severe or more advanced form of the same disease. And some have suggested that sclerosing mesenteritis might actually be a different disease that follows a different course. While mesenteric panniculitis tends to be stable and treatable, sclerosing mesenteritis might worsen.

The problem is that we still don’t know what causes the inflammation at the root of these conditions. Because of this, we don’t know why it occasionally causes more trouble for some people than others. We can say that most people with idiopathic inflammation in their mesentery have a stable and treatable condition. A few people have a more aggressive condition with more systemic inflammation that can go beyond their mesentery tissue.

Is mesenteric panniculitis serious?

It’s not life-threatening and rarely causes serious complications. Most people have mild to moderate symptoms, and they can go away on their own. But it can cause discomfort, and some people may need medication to treat it. Rarely, it might cause problems by interfering with your intestines. If swelling or scar tissue become too severe, they could obstruct the passage of food through your small intestine.

How common is this condition?

Mesenteric panniculitis is estimated to occur in about 1.5% of the population. Since it doesn’t always cause symptoms, and the symptoms it does cause are very common, it may be underdiagnosed.

Who does mesenteric panniculitis affect?

Mesenteric panniculitis is most common after the age of 60. It rarely affects people younger than 20. Some studies suggest it may be twice as common in people assigned male at birth than in people assigned female at birth.

(Video) What is Mesenteric panniculitis

Symptoms and Causes

What causes mesenteric inflammation?

The usual causes of inflammation are infection, injury and malignancy (cancer). This is true in your mesentery tissue as much as anywhere. Inflammation is a response from your immune system. It’s supposed to help tissues heal and help fight off things that might cause infections (pathogens). It’s strange when it occurs without a precipitating condition that needs healing. It’s almost like your immune system is making a mistake.

What can cause mesenteric panniculitis?

When your immune system produces a chronic inflammatory response without any disease or injury present, healthcare providers call it an “autoimmune response”. Your immune system is reacting automatically and inappropriately. Healthcare providers theorize that mesenteric panniculitis may be a type of autoimmune disease. These diseases occur in certain people under certain conditions.

Autoimmune diseases tend to run in families. People with mesenteric panniculitis often have a strong family history of autoimmune diseases. These diseases also are often triggered by some temporary condition that is supposed to produce a temporary immune response (like a virus). The immune response continues after the original condition has resolved. Mesenteric panniculitis has often been associated with these types of conditions.

For example:


Mesenteric panniculitis has been reported following abdominal surgery in about 5% of cases.


Previous infections might trigger mesenteric panniculitis. Some research has associated mesenteric panniculitis with a history of chronic infections like:

  • Tuberculosis.
  • Typhoid fever.
  • Cholera.
  • Syphilis.
  • Whipple’s disease.


Mesenteric panniculitis sometimes occurs in people who've been previously treated for cancer. It also sometimes occurs in people with known or soon-to-be-diagnosed cancer outside the mesentery. Previous or current cancer has been reported in up to 30% of cases. Types of cancer associated with mesenteric panniculitis include:

(Video) Sclerosing Mesenteritis : Causes, Diagnosis, Symptoms, Treatment, Prognosis

  • Lymphoma.
  • Carcinoid tumors.
  • Colon cancer.
  • Kidney cancer.
  • Prostate cancer.

Other sclerosing conditions

Mesenteric panniculitis sometimes develops in conjunction with other similar conditions in other places in the body. These conditions are characterized by chronic inflammation that causes progressive scarring (sclerosis or fibrosis). This suggests that whatever causes mesenteric panniculitis may trigger the same response in other places. Other sclerosing conditions that have been reported to occur with mesenteric panniculitis include:

  • Retroperitoneal fibrosis.
  • Sjogren’s syndrome.
  • Sclerosing pancreatitis.
  • Nodular panniculitis.
  • Crohn’s disease.

What are the symptoms of mesenteric panniculitis?

Some people have no noticeable symptoms, while others have many.

The most common symptom is abdominal pain. Inflammation can cause abdominal pain and swollen lymph nodes in the mesentery, which sometimes occur with mesenteric panniculitis.

In some people, abdominal pain is accompanied by:

  • Abdominal bloating.
  • Abdominal swelling.
  • Early satiety or loss of appetite.
  • Nausea and vomiting.
  • Constipation or diarrhea.
  • Weight loss.

These symptoms might result from the inflammation encroaching on your intestines.

Some people also have systemic symptoms, which affect your whole body and not just the abdominal area where your mesentery is. These symptoms, including fever and fatigue, are common when your immune system is involved.

Diagnosis and Tests

How is mesenteric panniculitis diagnosed?

Because it’s so rare and its symptoms are so vague, it often isn’t diagnosed right away. Your healthcare provider may have to rule out many other, more common conditions before they suspect mesentery panniculitis. They may begin with a blood test, which can show signs of inflammation. When they do suspect mesenteric panniculitis, they will use imaging tests (radiology) to look for its characteristic signs.

(Video) Keto tacos!!! WHAT in the heck is Mesentreric Panniculitis???

Mesenteric panniculitis is often recognizable on an MRI or CT scan. The radiologist will see characteristic thickening of the mesentery, signs of fat necrosis (fat cell death and calcification) and fibrosis. The fat tissue may be especially dense in one spot, giving the appearance of a mass. Lymph nodes in the mesentery may be swollen, but the blood vessels aren’t. This is one way of distinguishing mesenteric panniculitis from cancer.

The only definitive way of diagnosing mesenteric panniculitis is to take a tissue biopsy. That means surgically removing a piece of the mesentery tissue and sending it to a lab to analyze. But not everyone will need this kind of definitive diagnosis. Your healthcare provider may already have enough information to prescribe medication to treat mesenteric panniculitis. If the medication works, it also confirms the diagnosis.

Management and Treatment

How do you treat mesenteric panniculitis?

Not everyone needs treatment for mesenteric panniculitis. If you have no symptoms or mild symptoms, your healthcare provider may simply wait and watch it to see if your condition changes. Mesenteric panniculitis usually doesn’t get worse over time, and it often goes away on its own. If you do have symptoms, there are a few standard types of medications that healthcare providers use to treat them.

Corticosteroids, drugs that reduce inflammation, are the first line of treatment for mesentery panniculitis, and they often do the trick. In some cases, your healthcare provider may prescribe additional medications to treat side effects of the condition like nausea. These medications work gradually, so it may be weeks until your symptoms are gone.

If corticosteroids don’t work for you, your healthcare provider may prescribe immunosuppressants. These drugs suppress your overactive immune response. Or they may try low-dose naltrexone (LDN), which also works to modulate your immune system, but by a different approach. Healthcare providers use a trial-and-error process to find the best medication for your symptoms.

Outlook / Prognosis

What is my outlook with this condition?

In general, mesenteric panniculitis is usually short-lived. It may cause you little to no trouble at all. If you are among the minority who have chronic symptoms from mesenteric panniculitis, your symptoms are likely to respond to medication. Only a few people will have serious complications like a small bowel obstruction. Rarely, these people may need surgery to remove the obstruction.

(Video) Take Care of Your Mesentery for Better Health & Longevity!

Living With

Can diet help to manage mesenteric panniculitis?

An anti-inflammatory diet can help to reduce inflammation in your body, particularly in your digestive system. It’s not enough to make mesenteric panniculitis go away, but it could make a difference in your symptoms. An anti-inflammatory diet emphasizes whole foods — foods found in nature — over processed foods found in a package. It also emphasizes healthy, unsaturated fats.

Foods to avoid with mesenteric panniculitis include:

  • Red meat.
  • Processed meats.
  • Fried foods.
  • Packaged snacks.
  • Refined carbohydrates, such as white bread.
  • High-sugar products like soda.
  • Saturated fats, such as margarine, shortening and lard.
  • Alcohol.

Anti-inflammatory foods include:

  • Whole fruits, grains and vegetables.
  • Leafy green vegetables.
  • Fish such as salmon and tuna.
  • Plant oils, such as olive oil and canola oil.
  • Nuts such as almonds and walnuts.
  • Turmeric.

The Mediterranean diet is naturally anti-inflammatory. It emphasizes whole foods and healthy sources of omega-3 fatty acids, such as fish, nuts and olive oil.

A note from Cleveland Clinic

Mesenteric panniculitis is a rare condition with much still to be learned about it. Fortunately, it resolves quickly for many people. But if you’re among those whose symptoms are more difficult or persistent, it can be frustrating to have a condition that isn’t well understood. Treatments for mesenteric panniculitis are still experimental. A healthcare provider will work through the options with you, step by step.


Is there a special diet for mesenteric panniculitis? ›

I was just diagnosed with mesenteric panniculitis and what is the best foods found to relieve so far? My doc suggested the following, but not vegan: cut out or very limited sugar, dairy, caffeine (I have 1 cup of coffee a day then chamille tea), limited alcohol, decrease spicy and fried foods.

What not to eat with mesenteric panniculitis? ›

Foods to avoid with mesenteric panniculitis include:

Fried foods.

How do you get rid of mesenteric panniculitis? ›

Corticosteroid drugs are often used to treat mesenteric panniculitis. Other medicines that treat this condition include: azathioprine (Imuran) colchicine (Colcrys)

What causes mesenteric panniculitis to flare up? ›

Currently, there's no specific known cause of mesenteric panniculitis. Experts believe that the condition could be due to abdominal surgery, an autoimmune disease (immune cells start attacking the body), or bacterial infection. Mesenteric panniculitis causes persistent and long-term inflammation in the mesentery.

What foods are good for intestinal inflammation? ›

Suggestions for first foods after a flare include:
  • Diluted juices.
  • Applesauce.
  • Canned fruit.
  • Oatmeal.
  • Plain chicken, turkey or fish.
  • Cooked eggs or egg substitutes.
  • Mashed potatoes, rice or noodles.
  • Bread – sourdough or white.

What is the anti-inflammatory diet? ›

An anti-inflammatory diet favors fruits and vegetables, foods containing omega-3 fatty acids, whole grains, lean protein, healthful fats, and spices. It discourages or limits the consumption of processed foods, red meats, and alcohol. The anti-inflammatory diet is not a specific regimen but rather a style of eating.

What triggers panniculitis? ›

Possible causes of panniculitis include: infections, such as strep throat, tuberculosis, and pneumonia. autoimmune disorders, including Crohn's disease, ulcerative colitis, lupus erythematosus, and systemic sclerosis. physical causes, such as injury or cold temperatures.

What to avoid doing if you have stomach inflammation? ›

Preventive measures include:
  • Avoiding fatty, fried, spicy or acidic foods.
  • Cutting back on caffeine.
  • Eating smaller meals throughout the day.
  • Managing stress.
  • Not taking NSAIDs.
  • Reducing alcohol consumption.
  • Not lying down for 2 to 3 hours after a meal.
Sep 8, 2020

What can help panniculitis? ›

Medicines used to treat panniculitis include:
  • nonsteroidal anti-inflammatory drugs such as aspirin (Bufferin) or ibuprofen (Advil) to bring down inflammation and relieve pain.
  • antibiotics, such as tetracycline, to treat an infection.
  • hydroxychloroquine, an antimalarial drug, to bring down inflammation.

What causes inflammation in the mesentery? ›

The most common cause of mesenteric lymphadenitis is a viral infection, such as gastroenteritis — often called stomach flu. This infection causes inflammation in the lymph nodes in the thin tissue that attaches your intestine to the back of your abdominal wall (mesentery).

How is mesentery treated? ›

For the pain and fever of mesenteric lymphadenitis, have your child:
  1. Get plenty of rest. Adequate rest can help your child recover.
  2. Drink fluids. Liquids help prevent dehydration from fever, vomiting and diarrhea.
  3. Apply moist heat. A warm, moist washcloth applied to the abdomen can help ease discomfort.
May 20, 2021

What kind of doctor treats mesenteric panniculitis? ›

At Mayo Clinic, digestive disease specialists (gastroenterologists), radiologists, pathologists and surgeons work as a multidisciplinary team to care for people with sclerosing mesenteritis. Other professionals are included as needed.

What medications can cause panniculitis? ›

Drug-induced panniculitis is uncommon and usually induced by steroid treatment. Some cases of panniculitis induced by atenolol, potassium bromide, apomorphine, interferon alpha and interleukin 2 have been described.

How many people have mesenteric panniculitis? ›

Mesenteric panniculitis has been estimated to affect 1% of the population based on findings at over 700 post-mortem examinations. There is a slight male preponderance with a 1.8:1 ratio reported in some series.

How can I calm my intestinal inflammation? ›

Lifestyle and home remedies
  1. Limit dairy products. Many people with inflammatory bowel disease find that problems such as diarrhea, abdominal pain and gas improve by limiting or eliminating dairy products. ...
  2. Eat small meals. ...
  3. Drink plenty of liquids. ...
  4. Consider multivitamins. ...
  5. Talk to a dietitian.
Sep 3, 2022

What foods to avoid when you have inflamed intestines? ›

Foods to Avoid with IBD
  • Fatty, greasy or fried foods.
  • Hot or spicy foods.
  • Raw, high-fiber fruits and vegetables.
  • Nuts, seeds and beans.
  • Caffeinated or sugary beverages.
  • Alcoholic beverages.
  • Candy, sweets and other sources of added sugar.
Sep 4, 2020

What are easy digest foods? ›

The top 10 easy-to-digest foods include bananas, sweet potatoes, white rice, papaya, yoghurt, watermelon, kefir, chicken, kombucha, and eggs. In addition, probiotics (yoghurt, kefir, kombucha, tempeh) aid digestion and support gut health. Furthermore, one of the best foods for easy digestion is yoghurt.

What drink helps with inflammation? ›

Orange, tomato, pineapple and carrot juices are all high in the antioxidant, vitamin C, which can neutralize free radicals that lead to inflammation. Tart cherry juice has been shown to protect against gout flares and reduce OA symptoms.

Is peanut butter good for inflammation? ›

Are peanuts inflammatory? The short answer is no, and in fact, peanuts and some peanut products like peanut butter have been shown to be anti-inflammatory.

What are the 10 most inflammatory foods? ›

What foods cause inflammation?
  • Red meat and processed meats, including bacon, hot dogs, lunch meats and cured meats.
  • Refined grains, including white bread, white rice, pasta and breakfast cereals.
  • Snack foods, including chips, cookies, crackers and pastries.
  • Sodas and other sweetened drinks.
  • Fried foods.
Jun 29, 2022

Can mesenteric panniculitis disappear? ›

In general, mesenteric panniculitis is a chronic, benign disorder with a favorable prognosis that occasionally resolves on its own (spontaneous regression). Nonetheless, symptoms of mesenteric panniculitis may be severe in some patients and can result in significant effects on quality of life.

What breakfast is good for gastric problem? ›

Oatmeal is a heart-healthy food and, since oats absorb stomach acid, it's a good choice for reducing symptoms of gastroesophageal reflux disease (GERD). Liven up your oatmeal with tropical flavors such as papaya, which contains enzymes called papain that has been touted as a natural treatment for heartburn.

What is the best morning drink for gastritis? ›

Some people with gastritis can tolerate small amounts of cola or other caffeinated or caffeine-free carbonated soft drinks, but you're better off avoiding soda all together. Better beverage options include water, cranberry juice, and green tea, which has been linked to a decreased risk of gastritis and stomach cancer.

What helps inflammation in the stomach naturally? ›

Not all remedies will work for everyone, so a person may need to try several of these before finding what works best for them.
  1. Follow an anti-inflammatory diet. ...
  2. Take a garlic extract supplement. ...
  3. Try probiotics. ...
  4. Drink green tea with manuka honey. ...
  5. Use essential oils. ...
  6. Eat lighter meals. ...
  7. Quit smoking. ...
  8. Do not overuse NSAIDs.

What are the complications of mesenteric panniculitis? ›

Mesenteric panniculitis is usually benign, meaning the condition itself is not dangerous or cancerous. However, complications can occur. Severe inflammation can cause slowing and blockages in the intestines. This can make other symptoms worse, such as nausea and bloating.

Who treats Mesenteritis? ›

Departments that treat this condition
  • Colon and Rectal Surgery.
  • Gastroenterology and Hepatology.
  • General Surgery.
  • Laboratory Medicine and Pathology.
  • Radiology.
Sep 29, 2021

What organ is the mesentery associated with? ›

The mesentery is a fold of membrane that attaches the intestine to the abdominal wall and holds it in place.

What happens when the mesentery is damaged? ›

If not treated promptly, acute mesenteric ischemia can lead to: Sepsis. This potentially life-threatening condition is caused by the body releasing chemicals into the bloodstream to fight infection. In sepsis, the body overreacts to the chemicals, triggering changes that can lead to multiple organ failure.

What are the signs and symptoms of mesentery? ›

Symptoms of sclerosing mesenteritis include pain in your belly, vomiting, bloating, diarrhea and fever. Sometimes people don't have any symptoms.

Is mesenteric panniculitis an inflammatory bowel disease? ›

Mesenteric panniculitis (MP) is mostly an associated sign of an intra-abdominal or systemic inflammatory primary disease.

What foods should I avoid with mesenteric lymphadenitis? ›

Do not eat raw or undercooked chicken, turkey, seafood, beef, or pork. Drink safe water. Drink only treated water. Do not drink water from ponds or lakes.

What foods clog the lymphatic system? ›

9. Avoid Foods That Cause Blockages To The Lymphatic System
  • Processed foods.
  • Conventionally raised meat.
  • Artificial sweeteners.
  • Conventional dairy.
  • Sugar.
  • Soy.
  • Table salt.
Nov 1, 2021

How many cases of mesenteric panniculitis are there? ›

Mesenteric panniculitis has been described as “rare”,5 with a reported prevalence of between 0.16 and 3.4%, and a male:female predominance of 2 to 3:1 (5–7).

What drains to mesenteric lymph nodes? ›

Distinct nodes of the mesenteric lymph node (MLN) chain drain the small intestine (SI) and colon.


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