Mesenteric lymphadenitis: symptoms, causes, treatment and how long it lasts

Patient.info explains that the name comes from the mesentery, the part of the abdomen where the glands are located, and adenitis, which means inflamed lymph glands. It says most people know the lymph glands in the neck that swell with a sore throat or tonsillitis, and in the same way the lymph glands in the tummy, next to the gut, swell during an episode of mesenteric adenitis.

The NHS says swollen glands are usually a sign the body is fighting an infection. That general idea also applies here: the glands swell near the infection to help the body fight it.

The terms mesenteric adenitis and mesenteric lymphadenitis mean the same thing.

Patient.info describes it as usually a mild condition causing temporary tummy pain, often starting after a sore throat or flu-like symptoms. The main symptoms are:

• A sore throat or cold symptoms before the tummy pain started.

• Pain in the tummy, usually in the middle near the belly button, and sometimes in the lower right-hand side.

• A high temperature (fever) and feeling generally unwell.

• Feeling sick (nausea) and/or diarrhoea.

Patient.info says the most common cause is a viral infection, such as gastroenteritis. The germ triggers inflammation and swelling in the lymph glands, and the inflamed glands then cause pain, tenderness and a high temperature. Less often a bacterial infection, for example in the intestine, is the cause. It can also be caused by inflammatory bowel disease (IBD).

The NHS lists common causes of swollen glands in general as colds, tonsillitis and ear or throat infections, and sometimes viral infections such as glandular fever, and says swollen glands are rarely caused by anything more serious, such as leukaemia or lymphoma. The NHS says a stomach bug often causes watery poo, feeling sick and vomiting.

Patient.info says that usually no treatment is needed other than painkillers, if needed, and plenty of rest. If a bacterial infection is suspected you may be given antibiotics, but this is uncommon. Your doctor will explain which symptoms mean you should be seen urgently, and increasing pain or becoming more unwell mean you should seek further advice straightaway.

The NHS advice for swollen glands is to rest, drink plenty of fluids to avoid dehydration, and take painkillers like paracetamol or ibuprofen, and not to give aspirin to children under 16. For a stomach bug, the NHS says to drink lots of fluids, carry on breast or bottle feeding a baby, and avoid fruit juice and fizzy drinks. Ask a pharmacist or GP what is safe for you or your child.

Patient.info adds that in some cases appendicitis or ectopic pregnancy cannot be totally ruled out even after tests. Then an operation to look inside the tummy, usually keyhole surgery, may be needed to make sure nothing serious is missed. The purpose of such an operation is to make sure serious problems like appendicitis are not missed, not to look for swollen glands.

Patient.info says the symptoms usually improve within a few days and will almost always clear up completely within about two weeks. It says that rarely, if infection with a bacterium is the cause, the condition can become serious if left untreated. The NHS says swollen glands should go down within 1 to 2 weeks depending on the cause, and to see a GP if they are getting bigger or have not gone down within 1 week.

If the pain does not settle, keeps coming back or is getting worse, see a GP. The sources do not give a figure for how often it recurs.

Patient.info says that sometimes it is difficult to make a diagnosis or rule out other causes of tummy pain, such as appendicitis. The NHS says appendicitis usually starts with pain in the middle of the abdomen around the belly button, and after a few hours the pain usually moves to the lower right side and gets worse. Both conditions can therefore begin with similar pain.

Patient.info says it is usually diagnosed from symptoms, medical history and examination. If you or your child have typical symptoms and no signs of anything else, a doctor may think it likely. It is difficult to prove because the glands are deep in the tummy and cannot be seen or felt, so the diagnosis often involves excluding other problems and making a presumed diagnosis.

There is no specific test that proves it. Tests such as blood tests, a urine test for infection or ultrasound or CT scans may help rule out other conditions such as appendicitis. If the diagnosis is not clear, Patient.info says your doctor may suggest a wait and see approach with another check a few hours later, a referral to hospital for a surgeon's opinion, or tests. If there is any possibility of pregnancy, a pregnancy test is essential, because ectopic pregnancy can cause similar symptoms.

The NHS says there is no test that can always show appendicitis, that doctors sometimes wait a few hours in hospital to see how symptoms develop, and that scans such as ultrasound can check for swelling in the appendix.

Patient.info says it is a fairly common cause of tummy pain in children aged under 16 and much less common in adults. Adults can still get it. The NHS notes that appendicitis can have less typical pain in young children, so children with tummy pain that is getting worse deserve prompt assessment.

For a child, the NHS stomach ache advice is to ask for an urgent GP appointment or call NHS 111 if a stomach ache gets much worse, does not go away or keeps coming back. Never give aspirin to a child under 16.

The sources do not describe mesenteric lymphadenitis as something that passes from person to person. The infection that triggers it can be catching, though. The NHS says diarrhoea and vomiting can spread easily and advises staying off school or work until you have not been sick or had diarrhoea for at least 2 days, washing hands with soap and water often, and not preparing food for others.

No special diet is described in the sources. The NHS suggests eating when you feel able to, avoiding fatty or spicy foods if that helps, and drinking plenty of fluids when you have a stomach bug.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you or your child have tummy pain that is gradually getting worse or does not go away, or moves to the lower right side of the tummy. It says to call 999 or go to A&E for severe tummy pain, or confusion, blotchy or paler than usual skin or difficulty breathing, which could be signs of sepsis.

The NHS stomach ache page lists other reasons to go to A&E or call 999: a stomach ache that came on very suddenly or is severe, a tummy that hurts when you touch it, vomiting blood, bloody or black sticky poo, being unable to pass urine or poo or fart, chest pain or someone has collapsed.

For vomiting and diarrhoea, the NHS says to call 111 for a baby under 12 months, if a child stops feeding, or if there are signs of dehydration, bloody diarrhoea, or vomiting for more than 2 days.

On the NHS, a GP or urgent care doctor usually examines the child or adult, and may send them to hospital for a surgeon's opinion if appendicitis is possible. Some families choose a private paediatric or surgical review for speed; the assessment is the same, and the key point is that worsening pain should never wait for an appointment.