Mycotoxin-Triggered Attacks of Nausea, Vomiting, and Abdominal Pain and Episodes of Pseudo-Obstruction

Abstract

Determining the etiology of episodic abdominal pain, nausea and vomiting with and without pseudo-obstruction and implementing effective treatment can be challenging. Mycotoxins activate mast cells which rapidly degranulate releasing pro-inflammatory cytokines. Mast cells commonly reside in the gastrointestinal mucosa and adjacent to nerves. Aberrant mast cells with loss of control due to genetic abnormalities are present in mast cell activation syndrome, a common, yet often unrecognized multisystemic disorder. Mold exposure with consequent toxicity by its mycotoxins can present with complex multisystem disorders along with abdominal pain, nausea, and vomiting. A 63-year-old man presented with episodic attacks of abdominal pain, nausea and vomiting when he was exposed to dwellings with mold. Over a 4-year period he was admitted and there was radiographic evidence of dilation of the stomach and small intestine during three admissions and dilation of the colon in the other admission. When the patient was subsequently diagnosed and treated for underlying mast cell activation syndrome, the attacks ceased, and he has been healthy for the last three years. Recognition that mycotoxins can act as triggering factors is essential to effectively treat patients with and without mast cell activation syndrome who have these gastrointestinal attacks and episodic gastrointestinal pseudo-obstruction.

Symptom Clusters