{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:32:15Z","timestamp":1793291535697,"version":"4.5.0"},"reference-count":18,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,7]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>This is a case of mastocytic enterocolitis in a patient with a longstanding history of suspected diarrhoea-predominant irritable bowel syndrome (IBS-D).<\/jats:p>\n               <jats:p>A female patient in her 60s presents with a history of frequent diarrhoea with faecal urgency for several years. She underwent colonoscopy with gastrointestinal biopsies and immunohistochemical staining for CD117, demonstrating mast cell infiltration. The patient was diagnosed with mastocytic enterocolitis as she did not have symptoms or other findings suggesting systemic mastocytosis. Management with cromolyn sodium prior to meals was ineffective. Alternatively, management with H1 and H2 antihistamines and prebiotics provided significant clinical symptom improvement. In patients with refractory IBS-D, biopsies with immunohistochemical staining for mast cells should be considered. Prebiotic and probiotic supplementation, separately or combined, should also be considered and has not been previously described in the management of mastocytic enterocolitis.<\/jats:p>","DOI":"10.1136\/bcr-2025-266244","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T08:30:15Z","timestamp":1755765015000},"page":"e266244","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Mastocytic enterocolitis in a patient with chronic diarrhoea"],"prefix":"10.1136","volume":"18","author":[{"given":"Serena","family":"Tseng","sequence":"first","affiliation":[{"name":"Pediatrics, UC Davis Health, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohini","family":"Pathria","sequence":"additional","affiliation":[{"name":"Internal Medicine, UC Davis Health, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"2025082101300811000_18.8.e266244.1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.rgmxen.2021.08.007","article-title":"Approach to the adult patient with chronic diarrhea: A literature review","volume":"86","author":"G\u00f3mez-Escudero","year":"2021","journal-title":"Revista de Gastroenterolog\u00eda de M\u00e9xico (English Edition)"},{"key":"2025082101300811000_18.8.e266244.2","doi-asserted-by":"crossref","first-page":"362","DOI":"10.5858\/2006-130-362-MEIMMC","article-title":"Mastocytic enterocolitis: increased mucosal mast cells in chronic intractable diarrhea","volume":"130","author":"Jakate","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"2025082101300811000_18.8.e266244.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.22532"},{"key":"2025082101300811000_18.8.e266244.4","doi-asserted-by":"crossref","DOI":"10.4081\/ejh.2022.3499","article-title":"Is mastocytic colitis a specific clinical-pathological entity?","volume":"66","author":"Vernia","year":"2022","journal-title":"Eur J Histochem"},{"key":"2025082101300811000_18.8.e266244.5","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.100594"},{"key":"2025082101300811000_18.8.e266244.6","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/MPG.0000000000003588","article-title":"Identifying Mast Cells in Gastrointestinal Biopsies in Pediatric Irritable Bowel Patients","volume":"75","author":"Rizvi","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025082101300811000_18.8.e266244.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(05)80221-0"},{"key":"2025082101300811000_18.8.e266244.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2007.00523.x"},{"key":"2025082101300811000_18.8.e266244.9","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/1319-3767.101128","article-title":"Analysis of colonic mucosa mast cell count in patients with chronic diarrhea","volume":"18","author":"Zare-Mirzaie","year":"2012","journal-title":"Saudi J Gastroenterol"},{"key":"2025082101300811000_18.8.e266244.10","doi-asserted-by":"crossref","first-page":"280","DOI":"10.5217\/ir.2016.14.3.280","article-title":"Chronic intractable diarrhea caused by gastrointestinal mastocytosis","volume":"14","author":"Seo","year":"2016","journal-title":"Intest Res"},{"key":"2025082101300811000_18.8.e266244.11","article-title":"Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer","volume":"15","author":"Hu","year":"2023","journal-title":"Cureus"},{"key":"2025082101300811000_18.8.e266244.12","doi-asserted-by":"crossref","unstructured":"Yoo S , Jung SC , Kwak K , et al . The Role of Prebiotics in Modulating Gut Microbiota: Implications for Human Health. Int J Mol Sci 2024;1562\u20139. doi:10.1111\/j.1398-9995.2011.02771.x","DOI":"10.3390\/ijms25094834"},{"key":"2025082101300811000_18.8.e266244.13","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-82210-3","article-title":"Dietary fiber pectin alters the gut microbiota and diminishes the inflammatory immune responses in an experimental peach allergy mouse model","volume":"14","author":"Steigerwald","year":"2024","journal-title":"Sci Rep"},{"key":"2025082101300811000_18.8.e266244.14","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.202"},{"key":"2025082101300811000_18.8.e266244.15","doi-asserted-by":"crossref","DOI":"10.3390\/nu10101537","article-title":"Probiotics in autoimmune and inflammatory disorders","volume":"10","author":"Liu","year":"2018","journal-title":"Nutrients"},{"key":"2025082101300811000_18.8.e266244.16","doi-asserted-by":"crossref","unstructured":"Oksaharju A , Kankainen M , Kekkonen RA , et al . n.d. Probiotic Lactobacillus rhamnosus downregulates FCER1 and HRH4 expression in human mast cells. World J Gastroenterol2011 Feb 17:750\u20139. doi:10.3748\/wjg.v17.i6.750","DOI":"10.3748\/wjg.v17.i6.750"},{"key":"2025082101300811000_18.8.e266244.17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.immunol.17.1.931"},{"key":"2025082101300811000_18.8.e266244.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02771.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T08:30:18Z","timestamp":1755765018000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,21]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2025-266244"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266244","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}