Ménétrier disease, also known as hypertrophic gastropathy, is a rare, acquired disorder that affects the stomach lining, causing it to become thickened and inflamed. This unusual condition leads to an overgrowth of the mucous cells in the stomach, resulting in giant gastric folds, protein loss, and reduced acid production. Though still not fully understood, Ménétrier disease significantly affects digestive health and requires timely diagnosis and management.
Ménétrier disease is generally classified based on its onset and age of presentation:
Adult-Onset Ménétrier Disease (Chronic Form)
This form is most common and usually affects adults between the ages of 30 and 60. It progresses slowly over time and is often associated with an increased risk of gastric cancer.
Pediatric Ménétrier Disease (Acute Form)
Seen primarily in children, this version of the disease usually follows a viral infection, such as cytomegalovirus (CMV). Unlike the adult form, it tends to resolve spontaneously within a few weeks.
The symptoms of Ménétrier disease can be quite varied and often resemble other gastrointestinal conditions, which makes diagnosis challenging. Common signs and symptoms include:
Upper abdominal pain or discomfort
Nausea and vomiting
Loss of appetite and unintentional weight loss
Swelling (edema), especially in the legs or feet, due to protein loss
Fatigue and weakness
Diarrhea or gastrointestinal bleeding (less common)
Low protein levels (hypoalbuminemia) in blood tests
Malnutrition despite normal or increased food intake
The symptoms in children are similar but typically less severe and resolve faster.
A combination of tests is required to confirm the diagnosis:
Endoscopy – Visualizes the thickened folds in the stomach lining.
Biopsy – Tissue samples are examined to detect the characteristic overgrowth of mucous cells.
Blood Tests – Reveal low albumin levels, anemia, and other nutritional deficiencies.
Imaging Studies – CT or MRI scans may help detect changes in stomach structure.
Gastric pH Tests – Show decreased acid production in the stomach.
Since the symptoms can mimic other gastrointestinal diseases like gastritis, peptic ulcers, or stomach cancer, a biopsy is often essential for definitive diagnosis.
There is no universal cure for Ménétrier disease, but treatment focuses on symptom management and preventing complications:
High-protein Diet – To combat protein loss and malnutrition.
Albumin Infusions – For severe hypoalbuminemia.
Antacids or Acid Suppressors (PPIs) – Help manage stomach discomfort.
Cetuximab – A monoclonal antibody that targets the epidermal growth factor receptor (EGFR), shown to be effective in some adult cases.
Antiviral Therapy – Particularly in children if CMV is the cause.
Surgical Intervention – In chronic, severe, or cancer-prone cases, partial or total gastrectomy (removal of the stomach) may be necessary.
To manage the disease effectively, certain precautions and changes can help:
Avoid alcohol and smoking, which can aggravate the stomach lining.
Eat small, frequent meals rich in protein and low in fat.
Stay hydrated, especially if experiencing diarrhea or vomiting.
Avoid NSAIDs and other irritants that can damage the gastric mucosa.
Follow medical advice strictly, including all dietary and medication regimens.
Immediate medical consultation is recommended if you experience:
Persistent or worsening abdominal pain
Sudden weight loss without trying
Swelling in the legs or feet
Severe fatigue or signs of malnutrition
Vomiting blood or black, tarry stools (indicating gastrointestinal bleeding)
Early detection can significantly improve outcomes and help avoid complications such as stomach cancer or severe protein deficiency.
Ménétrier disease is a complex but manageable condition when addressed with timely medical care, a supportive diet, and appropriate monitoring. Ongoing research continues to explore targeted therapies that may offer hope for more effective and less invasive treatments in the future.
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