Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer

Chronic intractable diarrhea is a common presenting complaint that is often clinically worked up for a wide variety of diseases including inflammatory bowel disease, celiac disease, and hyperthyroidism. When lab results come back normal, patients are often diagnosed with irritable bowel disease-diarrheal subtype, overlooking the potential diagnosis of mastocytic enterocolitis. Mastocytic enterocolitis is an uncommon diagnosis where patients can benefit from mast cell stabilizers that directly target the underlying pathology. Given the broad differential diagnosis of nonspecific diarrhea presentation, a histopathological examination is warranted for definitive diagnosis. We hope to raise awareness of this potentially treatable disease that can be effectively managed with antihistamines. We describe the case of a 63-year-old male patient with a family history significant for colon cancer who presented with intractable diarrhea and was ultimately diagnosed with mastocytic enterocolitis by histopathology. His symptoms were relieved by antihistamine treatment.