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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 950582, 6 pages
http://dx.doi.org/10.1155/2012/950582
Research Article

Allergic Mastocytic Gastroenteritis and Colitis: An Unexplained Etiology in Chronic Abdominal Pain and Gastrointestinal Dysmotility

1Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, 1600 SW Archer Road, HD512A, P.O. Box 100214, Gainesville, FL 32610, USA
2Section of Digestive Diseases and Nutrition, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
3Department of Medicine, Mercy Medical Center, Chicago, IL 60616, USA
4Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA

Received 23 September 2011; Revised 17 November 2011; Accepted 18 November 2011

Academic Editor: Giovanni Barbara

Copyright © 2012 A. Akhavein M et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders. Emerging data suggests that these symptoms may be associated with mast cell excess and/or mast cell instability in the GI tract. The aim of this retrospective study was to evaluate the contribution of mast cells to the aforementioned symptoms in individuals with a history of atopic disease. A retrospective chart review of individuals seen in a university GI practice was conducted and twenty-four subjects were identified. The majority had abdominal pain, early satiety, and nocturnal awakening. 66.7% and 37.5% had a history of environmental and/or food allergy. Solid gastric emptying was increased as were the mean number of mast cells reported on biopsies from the stomach, small bowel, and colon (>37/hpf) by CD117 staining. Mean whole blood histamine levels were uniformly elevated. This study suggests that in individuals with these characteristics, consideration should be given to staining their gastrointestinal biopsies for mast cells as this may provide them with relatively non-toxic but highly targeted treatment options. Allergic gastroenteritis and colitis may represent a third type of GI mast cell disorder along with mast cell activation syndrome and mastocytic enterocolitis.