Issue link: https://www.massageandbodyworkdigital.com/i/1488451
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 73 TAKEAWAY: Massage is unlikely to fix or cure MCAS, but with care, knowledge, and sensitivity, MTs can create an experience for clients that feels safe and supportive of their wellness goals. The causes of MCAS are not understood. One of its most mysterious features is that the triggers of episodes can vary and change over time. This makes it sound like multiple chemical sensitivity syndrome (MCSS), a condition in which a history of exposure to toxins appears to initiate a heightened tendency toward allergic reactions to an ever-widening collection of stimuli. The overlap of MCAS, MCSS, and several other conditions is discussed in the sidebar, "Partners in Inf lammation." MCAS SIGNS, SYMPTOMS, AND DIAGNOSIS The primary signs and symptoms of MCAS involve frequent, often extreme allergic reactions that affect more than one body system. The respiratory tract, gastrointestinal tract, and the skin are most at risk for these reactions. The main driver for these signs and symptoms is histamine. This chemical mediator causes dilation of both small and large blood vessels, which causes skin reddening, f lushing, hives, itching, and pain. In the respiratory tract, histamine causes excess mucus production, runny and itchy nose, congested sinuses, and tightened airways, which leads to wheezing, shortness of breath, and a specific breath-sound called stridor. In the GI tract, histamine causes excessive acid production and inf lammation in the intestines, leading to nausea, vomiting, diarrhea, constipation, and cramping. Other general symptoms can include chronic pain, headaches, and fatigue. The most serious consequence of excessive histamine release is anaphylaxis (from Greek for "guarding against"). This is a system-wide situation with a rapid drop in blood pressure, faintness, tachycardia, and swelling in the extremities. Anaphylaxis is a medical emergency, and people with MCAS are at high risk for anaphylactic episodes. MCAS is a complex situation that affects multiple organ systems—usually some combination of the skin, respiratory tract, and gastrointestinal tract. It involves f luctuating and often unpredictable bouts of extreme inf lammation that can be painful and even life- threatening if it leads to anaphylaxis. WHAT CAUSES MCAS? To understand MCAS, we need to learn a bit about mast cells. These are large white blood cells born in the bone marrow and distributed in many tissues. They are especially populous near the skin, in the respiratory tract, and in the GI tract. This makes sense since these are parts of the body most likely to be on the receiving end of any environmental threats or invaders. When mast cells are stained and seen under a microscope, they show tiny granules—pockets of chemicals. For this reason, they are called granulocytes. When mast cells release these chemicals, this is called "degranulation." During degranulation, mast cells secrete a group of chemical mediators. These promote inf lammatory responses, including vasodilation, local edema, f lushing, excess mucus production, and other reactions often associated with allergic reactions. Histamine is a well- known mediator, but several others are also involved. Testing for high levels of these chemicals in the blood or urine is part of the diagnostic process for MCAS. When mast cells behave normally, they degranulate in response to some stimulus. This is called secondary activation because it comes after a trigger. (Primary activation—degranulation without an initiating stimulus—is a sign of mastocytosis, which is potentially very serious.) Secondary mast cell activation is a normal, healthy response that protects us from the action of antigens— any bits of "non-self." But when mast cells become hyperreactive, degranulating in response to a wide variety of changing triggers, it can become a problem that ranges from being mildly irritating to life-threatening.