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Forum Name: Lymphoma

Question: Mesenteric Lymphadenopathy


 bindy - Sat Feb 10, 2007 6:43 am

Hi,
I am 16 and for over a year now, i have had upper abdominal pain in 'the GI area' (doctors have referred to it as this). The pain is always present. Never goes away, and it seems that when i'm active (doing sport, walking around, carring my school bag) the abdominal pain ceases slightly. However when i stop, the pain seems worse. Though sometimes the increased pain afterwards doesn't become unbearable until an hour or so later sometimes more. This made me think it was muscular for months but i've been told if it was muscular it shouldn't still be causing problems. Sometimes the pain is more of a discomfort and other times it becomes more of a neaeus feeling. When the pain becomes unbearable i use a hot water bottle and i've found that it gives me some relief.

I've had an endoscopy and had biopsy's done and they came back 'normal'. I've had multiple blood tests and have just recently had yet another one and a urine sample taken. I recieved a form from my current specialist (being muscle and bone specialist) to go have another urine sample taken [i haven;t been back to him since the last one was done just over 2 weeks ago. wether this is a good sign that he's seen soemthign or not i don't know?

Anyway i also had a CT scan done since my last appointment. And the report i got back with that mentioned that i have mesenteris nodes in my large bowel. As well, as bilateral ovarian cysts. Now the ovarian cysts i know can be phisiological so i'm not to worried about that but i don't know much about the mesenteric nodes. So any info would be appreciated.

However i have been browsing the internet for any information that i can get on upper abdominal pain and these findings from the CT scan and i came across "Mesenteric Lymphadenopathy " and from what i've read of that. it seems to make sense of my symptoms. However there isn;t alot of 'relevant' information about it on the internet (not that i have found anyway) and i woudl liek a bit of information about it (if possible).

Also, it does mention chemo theropy??? and somethign about this Mesenteric Lymphadenopathy which mentions that it's actually tumors ???? I'm aconfused and am impatiently wait to go back to my specialist but was just wanting some info (mainly to put my mind at rest).

if anyone can give me any information on this: Mesenteric Lymphadenopathy then i woudl really appreciate it.
 Dr. Chan Lowe - Sat Feb 10, 2007 1:44 pm

User avatar HI Bindy,

Mesenteric lymphadenopathy can be a source of abdominal pain. In fact, many people have gone to the operating room for appendicitis only to find that the appendix was normal and they had inflamed mesenteric nodes (known as mesenteric adenitis).

It would be unusual for mesenteric adenitis to last a year. Typically it is only a few days to weeks in course. The mesenteric lymph nodes function in essentially the same way that the rest of the body's lymph nodes do. They are the watchmen of the immune system, constantly sampling things to see if there are any foreign invaders. I suppose that if there was chronic exposure to an offending agent the nodes could remain enlarged and cause continuing pain.

Abdominal pain is quite difficult to work up and it appears that all the right things are being done. An endoscopy and biopsy would have discovered H. pylori (a bacteria that can cause ulcers and gastritis). Have you had your pancreatic enzymes checked (amylase and lipase)? Chronic low level pancreatitis can cause pain (again, typically not for a year but possible).

Have you lost any weight? Also, a very common cause of ongoing abdominal pain is an undiagnosed food allergy. Unfortunately, however, typical allergy testing is NOT helpful-despite many physicians continued use of them- in determining food allergies as the allergic reaction is not IgE mediated (which the skin prick tests look for). Really, the best way to determine food allergies is to do an elimination diet.

The foods which cause the far majority of food allergies include: dairy, wheat, peanuts, tree nuts, fish, shell fish, soy, and eggs. If you are able to avoid these foods for 2-4 weeks and the pain gets better it is almost certainly a food allergy to one of these things. At that point, you can add them back one at a time to see which one causes the pain to return. Then avoid that food.

I recommend continuing to follow up with your GI specialist to work this out. Also, while often incidental, ovarian cysts can cause pain. Gynecologists will often recommend waiting for 3-6 months to see if the cysts resolve on their own. They may also consider using 3-6 months of oral contraceptives to better regulate the hormones and "help" the cysts resolve. This may be something you can pursue to see if you can get a little relief from it.

Hope this helps. Keep us updated.

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