Gastrointestinal problems are very common in systemic mastocytosis (SM): Up to 80% of patients experience symptoms related to the digestive tract.
How SM affects gut health
In SM, mast cells can accumulate abnormally in the digestive tract. These cells release histamine and other chemicals that can irrigate the gut, and may increase the amount of gastric acid the stomach produces. Together, mast cells and the chemicals they release can lead to symptoms like:
- Stomach pain.
- Acid reflux, where stomach acid moves into the esophagus.
- Stomach ulcers.
- Inflammation of the stomach (called gastritis).
- Nausea.
- Vomiting.
- Bloating.
Stomach ulcers are one of the most common symptoms: Up to 50% of people with SM get peptic ulcers, open sores in the stomach or intestine. These can cause stomach pain and bleeding.
In addition, chemicals released by mast cells lodged in the gut can cause problems with gut motility, which is how food moves through the digestive tract. This can lead to changes in bowel habits, such as constipation and diarrhea, and can also cause abdominal pain and cramps.
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Other effects on the digestive system
Over time, SM’s gastrointestinal impact can become significant.
The digestive system’s ability to absorb important nutrients can be impacted, which can lead to vitamin deficiencies, weakness and weight loss.
In aggressive SM, the liver and the spleen are often affected. These organs play an important role in detoxification and the maintenance of a healthy immune system, but also tie into the digestive system. The liver produces bile, which allows the body to break down fats and absorb fat-soluble nutrients.
How to address symptoms
If you’re experiencing gastrointestinal symptoms, talk to your care team.
In some cases your doctor might recommend an endoscopy examination, which uses a flexible tube with a camera that is maneuvered through your gut to visualize what is wrong. These tests allow doctors to rule out other potential causes of gastrointestinal problems. Once doctors gain a firm grasp of what is going on in your gut, they can recommend the best treatments for your symptoms.
Read about SM Companion ambassador Tara Keith’s experience: “Getting a colonoscopy with SM: Embarrassing? Maybe! Worth it? Yes!”
Depending on your symptoms and case, your doctor may recommend H2 blockers — a type of medication that helps reduce stomach acid production — and other medications that help control histamine release. As with many aspects of SM, avoiding triggers is also an important part of easing gastrointestinal symptoms.
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