Multiple Chemical Sensitivities (MCS) -: challenges of modern diagnosis and treatment

Multiple Chemical Sensitivities ("MCS") are a clinical syndrome which is characterized by recurrent multiple unspecific symptoms and signs of different organ systems and which can result as reaction to multiple chemically not related substances. It concerns a pathophysiologically not elucidated hypersensitivity to different chemical challenges in lowest concentrations which healthy persons are usually tolerate. Until now, MCS is not accepted scientifically. No scientific consensus exists about the different etiological and pathophysiological concepts. Therefore, there are no scientifically based diagnostic strategies. NICS can only be diagnosed by exclusion. That's the reason that somatic and psychologic differential diagnostics is of central importance in the diagnostic procedere of suspected MCS. Because of a missing obligatory case definition and the multitude of pathophysiological concepts a causal therapy cannot be offered. Supportive treatment is to the fore in therapeutic attempts. This includes hygienically and preventively based minimization or avoidance of exposures as well as different psychotherapeutic issues to enable a normal social life. Although scientifically validated diagnostics and therapy are still not available, an extremely involved number of different partly not validated methods is used in practice. These methods are expensive, often ineffective or harmful and charge the solidarity committee. A final, definite and comprehensive definition of MCS is necessary, not only from the ethic and moral point of view but also for scientific purposes and because of the increasing importance in social medicine. Especially, the methods of diagnostics and therapy, which have already been applied but not yet validated, must be investigated scientifically because by choosing the therapist the affected persons decide on the method of diagnostics and therapy.