From the Research
The treatment for mesenteric panniculitis typically involves a combination of medications and supportive care, tailored to symptom severity, with corticosteroids like prednisone and tamoxifen being commonly used to reduce inflammation and fibrosis. For mild cases, observation alone may be sufficient as the condition can resolve spontaneously 1. When treatment is needed, the therapeutic approach targets the underlying inflammatory process that characterizes mesenteric panniculitis, where fat tissue in the mesentery becomes inflamed and eventually fibrotic.
Some key points to consider in the treatment of mesenteric panniculitis include:
- The use of corticosteroids, such as prednisone, to reduce inflammation, with a typical starting dose of 40-60mg daily and gradual tapering as symptoms improve 1
- The addition of tamoxifen, at a dose of 10-20mg twice daily, to help decrease fibrosis through its antifibrotic properties 1
- The potential use of immunosuppressants, such as azathioprine, cyclophosphamide, or methotrexate, for patients with more severe symptoms 2
- The effectiveness of colchicine, at a dose of 0.6mg once or twice daily, due to its anti-inflammatory effects, as demonstrated in a case report where steroid dependence was successfully managed with colchicine 3
- The importance of pain management with NSAIDs or, in severe cases, opioid analgesics, as well as nutritional support, especially if the condition affects digestion or causes bowel obstruction 4, 5
It's worth noting that while surgical resection may be attempted for definitive therapy, the surgical approach is often limited, and emergency surgery may be required in some cases, as reported in a study of three cases where patients required emergency abdominal surgery and partial jejunal resection 5. However, the primary goal of treatment is to manage symptoms and reduce inflammation, with the most recent and highest quality study supporting the use of medications and supportive care as the primary treatment approach 1.