Sclerosing Mesenteritis: Complete Guide to Symptoms, Causes, Diagnosis, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Sclerosing mesenteritis is an uncommon condition in which the mesentery, the tissue that holds the intestines in place, becomes inflamed and forms scar tissue. The cause is not known, and many people have no symptoms at all, which means they may never need treatment. When symptoms do occur, they include belly pain, bloating, diarrhea, constipation, and unintended weight loss, and it is most often diagnosed in people in their 50s or 60s. A CT scan is the primary diagnostic tool, and the most common treatment is a combination of tamoxifen and a corticosteroid such as prednisone.
What Is Sclerosing Mesenteritis?
Sclerosing mesenteritis (skluh-ROHS-ing MEZ-un-tuh-rie-tis) is an uncommon condition in which the tissue that holds the intestines in place becomes inflamed and forms scar tissue. This tissue is called the mesentery (mez-un-TER-ee). It is not clear what causes sclerosing mesenteritis.
The condition can cause belly pain, weight loss, diarrhea, constipation, and other symptoms. But many people experience no symptoms and may never need treatment. In rare cases, scar tissue can block food from moving through the digestive tract. In this case, surgery may be needed.
The condition goes by other names, including mesenteric panniculitis (puh-NIK-u-lie-tis) and misty mesentery.
| Key Fact | Detail | | --- | --- | | Type of condition | Uncommon inflammatory condition of the mesentery | | What happens | Mesentery becomes inflamed and forms scar tissue | | Scar tissue pattern | Usually one single, relatively large mass; sometimes multiple smaller clusters | | Other names | Mesenteric panniculitis; misty mesentery | | Cause | Not known | | Who is affected | Most often diagnosed in people in their 50s or 60s | | Symptom outlook | Many people have no symptoms and may never need treatment | | Treatment goal | Manage symptoms; surgery in rare cases of digestive blockage |
What Is the Mesentery?
The mesentery is tissue that attaches the small intestine and colon to the back wall of the belly cavity. It is one of the tissues lining the belly cavity, found at the back of the belly cavity.
The mesentery also houses blood vessels and nerves that serve these organs. It holds immune system tissues called lymph nodes, along with lymph vessels, and stores fat cells that help regulate nutritional balance in the body.
| Function of the Mesentery | What It Does | | --- | --- | | Attachment | Attaches the small intestine and colon to the back wall of the belly cavity | | Blood supply | Houses blood vessels and nerves that serve the small intestine and colon | | Immune support | Holds lymph nodes and lymph vessels | | Nutrition | Stores fat cells that help regulate nutritional balance in the body |
What Causes Sclerosing Mesenteritis?
The cause of sclerosing mesenteritis is not known.
Sclerosing mesenteritis happens when the mesentery becomes inflamed and forms scar tissue. Inflammation is typically the immune system's reaction to disease or injury. An inflammatory reaction increases blood flow, releases proteins that regulate cells' defenses, and delivers disease-fighting cells. Inflammation is usually a part of a healing process, but long-term inflammation damages tissues.
What causes long-term inflammation in sclerosing mesenteritis is not known. Scar tissue from the inflammation usually appears as a single, relatively large mass. Sometimes there are multiple smaller clusters of scar tissue.
Risk Factors
Sclerosing mesenteritis is most often diagnosed in people in their 50s or 60s.
People with a history of certain conditions may be at increased risk. A history of belly surgery, traumatic injury to the belly, cancer or other diseases in the belly, or autoimmune diseases that result in the immune system attacking the body's own tissue can all raise risk.
| Risk Factor | Detail | | --- | --- | | Age 50s–60s | Most often diagnosed in this age range | | Prior belly surgery | History may increase risk | | Traumatic injury to the belly | History may increase risk | | Cancer or other diseases in the belly | History may increase risk | | Autoimmune diseases | Immune system attacking the body's own tissue may increase risk |
Sclerosing Mesenteritis Symptoms
Symptoms of sclerosing mesenteritis may include belly pain or tenderness, bloating, diarrhea, constipation, upset stomach and vomiting, unintended weight loss, and fever.
Many people with sclerosing mesenteritis have no symptoms at all.
| Symptom | What It Looks Like | | --- | --- | | Belly pain or tenderness | Pain or tenderness in the abdomen | | Bloating | A feeling of fullness or swelling in the belly | | Diarrhea | Loose or frequent stools | | Constipation | Difficulty passing stools | | Upset stomach and vomiting | Nausea with vomiting | | Unintended weight loss | Losing weight without trying | | Fever | Elevated body temperature | | No symptoms | Many people with the condition feel nothing at all |
When to See a Doctor
Many conditions can cause belly pain, weight loss, and other symptoms of the digestive system. It is important to see your healthcare professional if you have symptoms that do not improve with self-care and rest for a few days.
See your health professional if you have unintended weight loss.
Possible Complications
Some people with sclerosing mesenteritis develop complications. These can include blockage or irregular movement of waste in the small intestine and decreased blood flow to the small intestine.
Blood clots can form in the main blood vessel to the mesentery. Blockage of the lymphatic system in the belly can occur, as can kidney failure or other conditions of the urinary system.
| Complication | What It Involves | | --- | --- | | Bowel blockage | Blockage or irregular movement of waste in the small intestine | | Decreased blood flow | Reduced blood flow to the small intestine | | Blood clots | Clots in the main blood vessel to the mesentery | | Lymphatic blockage | Blockage of the lymphatic system in the belly | | Urinary issues | Kidney failure or other conditions of the urinary system |
How Is Sclerosing Mesenteritis Diagnosed?
In some cases, sclerosing mesenteritis is found during belly surgery or on imaging tests for other conditions. Your healthcare professional will ask you questions about your symptoms and medical history.
A diagnosis is based on a complete physical exam, which includes gently touching the belly to find the site of pain or tenderness. In some cases, a mass can be felt in the belly.
| Diagnostic Step | What It Shows | | --- | --- | | Physical exam | Complete exam; gently touching the belly to find the site of pain or tenderness; sometimes a mass can be felt | | CT scan | The primary tool for diagnosing sclerosing mesenteritis; creates cross-sectional images of tissues; sometimes found during a CT for unrelated symptoms | | Tissue sampling (biopsy) | Removed for laboratory testing if symptoms are severe or if CT imaging or symptoms suggest a cancer diagnosis; usually removed with surgery through small incisions, called a surgical biopsy |
Treatment Options
The goal of treatment is to manage symptoms. You may not need treatment if you have no symptoms or complications from sclerosing mesenteritis.
Medicines
The most common treatment is a combination of tamoxifen (Soltamox) and a corticosteroid, such as prednisone. The dose of corticosteroid is reduced over three months because of the side effects of long-term use.
Tamoxifen may increase the risk of blood clots. It is not prescribed to people at risk of blood clots or those who have a family medical history of blood clots. Other medicines may be used for people who cannot take tamoxifen or tolerate other side effects of the medicine. Research on the effectiveness of other treatments is limited.
| Medicine | Role in Treatment | | --- | --- | | Tamoxifen (Soltamox) | Core medicine; not given to people at risk of blood clots or with a family history of clots | | Corticosteroid (e.g., prednisone) | Combined with tamoxifen; dose reduced over three months to limit long-term side effects | | Other medicines | Used for people who cannot take tamoxifen or tolerate its side effects; research on effectiveness is limited |
Surgery
Surgery may be needed if a mass in the belly blocks food from moving through the digestive tract.
Follow-up
Follow-up CT scans may be ordered, particularly if there are changes in symptoms or new symptoms.
Preparing for Your Appointment
You may start by seeing your primary healthcare professional, or you may be referred to a specialist in digestive diseases called a gastroenterologist.
When you make the appointment, ask if there is anything you need to do in advance, such as fasting before having a specific test. Take a family member or friend along if possible, to help you remember the information you are given.
Make a list of your symptoms, including any that seem unrelated to the reason for your appointment. Include key personal information, such as major stresses, recent life changes, and family medical history. List all medicines, vitamins, or other supplements you take, including the doses and the reason for taking each one, along with questions to ask your healthcare professional.
| Questions to Ask | What the Doctor Will Likely Ask | | --- | --- | | What's likely causing my symptoms? | When did your symptoms begin? | | What tests do I need? | Do your symptoms come and go, or are they constant? | | What's the best course of action or treatment? | How severe are your symptoms? | | I have other health conditions — how can I best manage them together? | What improves or worsens your symptoms? | | Are there restrictions I need to follow? | Do you have a history of belly surgery? | | Should I see a specialist? | Have you had a belly injury? | | How can I manage symptoms until we have a diagnosis? | Have you had unintended weight loss, and how much? | | Are there brochures or websites you recommend? | — |
Conclusion
Sclerosing mesenteritis is an uncommon condition in which the mesentery becomes inflamed and forms scar tissue. The cause is not known, and the outlook for many people is reassuring: many have no symptoms and may never need treatment. When symptoms such as belly pain, bloating, unintended weight loss, or changes in bowel habits do appear, a CT scan is the primary diagnostic tool, and treatment focuses on managing symptoms with a combination of tamoxifen and a corticosteroid.
Take the next step: If your digestive symptoms do not improve with self-care and rest within a few days, or if you experience unintended weight loss, talk to a healthcare professional.
Frequently Asked Questions
1. What is sclerosing mesenteritis?
Sclerosing mesenteritis is an uncommon condition in which the mesentery, the tissue that holds the intestines in place, becomes inflamed and forms scar tissue. It is also called mesenteric panniculitis or misty mesentery.
2. What causes sclerosing mesenteritis?
The cause is not known. The mesentery becomes inflamed and forms scar tissue, usually appearing as a single, relatively large mass or sometimes multiple smaller clusters, but what triggers the long-term inflammation is not understood.
3. Is sclerosing mesenteritis serious?
Many people experience no symptoms and may never need treatment. However, in rare cases scar tissue can block food from moving through the digestive tract, which may require surgery, and some people develop complications such as decreased blood flow or blood clots in the mesentery.
4. What are the symptoms of sclerosing mesenteritis?
Symptoms may include belly pain or tenderness, bloating, diarrhea, constipation, upset stomach and vomiting, unintended weight loss, and fever. Many people have no symptoms at all.
5. Who gets sclerosing mesenteritis?
It is most often diagnosed in people in their 50s or 60s. People with a history of belly surgery, traumatic injury to the belly, cancer or other diseases in the belly, or autoimmune diseases may be at increased risk.
6. How is sclerosing mesenteritis diagnosed?
A CT scan is the primary tool for diagnosing sclerosing mesenteritis. A complete physical exam can find the site of pain or tenderness and sometimes a belly mass. A surgical biopsy may be done if symptoms are severe or if cancer is suspected.
7. How is sclerosing mesenteritis treated?
The goal of treatment is to manage symptoms. The most common treatment is a combination of tamoxifen and a corticosteroid such as prednisone, with the steroid dose reduced over three months. Surgery may be needed if a mass blocks food from moving through the digestive tract.
8. What is the best treatment for sclerosing mesenteritis?
The most common treatment is a combination of tamoxifen (Soltamox) and a corticosteroid such as prednisone. Tamoxifen is not prescribed to people at risk of blood clots or with a family history of clots, and other medicines may be used for people who cannot take it, although research on other treatments is limited.
Trusted External Resources
Medical disclaimer: This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about any medical condition or treatment decision.
Comments