Ménétrier's Disease

Ménétrier’s disease is a digestive disorder, which is named after a French physician called Pierre Eugene Ménétrier, who first described the condition in 1888. It is a rare condition and is characterised by small ridges of tissue in the stomach wall, known as rugae, which become enlarged. The rugae, which start to resemble large folds of tissue, become larger as a result of the mucous cells in the stomach increasing in size. When the rugae are enlarged, they produce too much mucus and this causes protein to leak into the stomach from the blood. When protein leaks from the blood, this causes a condition known as hypoproteinemia.

The condition is rare and tends to affect men more often than women. It is most common in men aged between 30 and 60.

Other conditions can cause the rugae to become inflamed, which include:

• Zollinger-Ellison syndrome.
• Cytomegalovirus.
• Linitis plastica.
• Syphilis.
• Histoplasmosis.

Ménétrier’s disease may also be referred to as hypertrophic gastropathy, protein losing gastropathy and giant hypertrophic gastritis.

What causes Ménétrier’s disease?

The exact cause of Ménétrier’s disease is unknown, but it is believed that there is no genetic link to the disease. Some research studies suggest that people with Ménétrier’s disease produce an abnormally high level of a protein called transforming growth factor-alpha; growth factors instruct the cells telling them to grow bigger, divide or change their shape, for example. It is not known why some people produce too much transforming growth factor-alpha.

What are the symptoms of Ménétrier’s disease?

Symptoms of Ménétrier’s disease include:

• Severe abdominal pain (in the top of the abdomen towards the centre).
• Loss of appetite.
• Swelling in the face, legs, arms, feet and abdomen.
• Low levels of blood protein.
• Anaemia.
• Diarrhoea.
• Nausea.
• Sickness.
• Weight loss.
• Malnutrition.
• Vomiting blood.

Complications of Ménétrier’s disease

There is evidence to suggest that Ménétrier’s disease is linked to an increased danger of stomach cancer.

How is Ménétrier’s disease diagnosed?

Various tests can be used to diagnose Ménétrier’s disease, including X-rays, a biopsy test and an endoscopy. If you feel unwell or you experience symptoms, you should visit your General Practitioner. They will question you about relevant symptoms of the condition, your medical history and also carry out an examination. If your GP thinks you have Ménétrier’s disease, they will refer you for X-rays and an endoscopy.

An Endoscopy is a test which enables doctors to see the interior of the body in detail. The test involves inserting a thin, flexible tube called an endoscope down the throat and into the digestive system or up the back passage. An Endoscope has a light source and a camera, which sends images of the interior of the body to an external monitor for doctors to analyse. A biopsy test involves taking a very small sample of tissue, which is then sent to a laboratory for pathologists to analyse. A type of endoscopy test known as a gastroscopy is usually used to diagnose Ménétrier’s disease. This test allows doctors to see the oesophagus, stomach and duodenum (the first part of the small intestine) in detail.

Treatment for Ménétrier’s disease

Treatment for Ménétrier’s disease may be determined by the severity of the condition. Medication can be prescribed to ease symptoms, including pain and nausea, but if the condition is severe surgery may be required to remove part of the stomach. People with Ménétrier’s disease may be advised to consume a diet high in protein and you will be given further advice about which foods to eat by a dietician or nutritionist.