The POTScast Zac Spiritos, MD, MPH on neurogastroenterology with Dr. Tania Dempsey on Mast Cell Matters
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Jan 13, 2026 Dr. Zac Spiritos, a dual board-certified gastroenterologist specializing in IBS and POTS, shares his journey into complex internal medicine. He reveals how pivotal patient encounters led him to effectively treat mast cell activation syndrome (MCAS) and discusses the importance of functional mast cell activity over static counts. Zac also dives into innovative treatment strategies using GLP-1 agonists and critiques common diagnoses like SIBO. He emphasizes empowering patients with tailored diet advice while being cautious about overly restrictive elimination diets.
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Turning Point Patient Case
- Dr. Zac Spiritos described a patient with IBS, POTS, and menorrhagia who improved dramatically after H2 and H1 blockers.
- That case sparked his deep interest in mast cell activation and changed his clinical focus.
Rising Recognition Of Mast Cell Disorders
- Mast cell diagnoses are rising rapidly, possibly from increased recognition or post-viral triggers like COVID.
- The condition likely existed for decades but is now more visible to clinicians and patients.
Broaden Differential For Young GI Patients
- When assessing GI symptoms, broaden the differential beyond common diagnoses like GERD for young, non-obese patients.
- Look for connective tissue, dysautonomia, and allergic clues that change interpretation and management.