I always appreciate puns.
I have had severe, sudden diarrhea after eating before. Looking back, after learning about
MCAS, I was able to trace it to a very high-histamine meal immediately beforehand. The last one was decaf coffee (not the mold-free kind), pickled cauliflower, and a large chocolate chip
cookie for my birthday. My body decided it was very offended by all of that. I also wonder if SIBO can play a role - like our intestines are already irritated and low-grade reactive because of the SIBO, and then we offended it with an MCAS trigger and they flip out? Not sure.
Nerve pain for me has been constant for periods of time, but went away almost entirely when I started treating MCAS. That said, addressing MCAS for me included curcumin and DNRS, which can have their own effects on nerve pain, regardless of MCAS status, so I'm not sure whether to lump my nerve pain in with MCAS or not.
MCAS can vary in severity. When someone is in a severe MCAS flare, then they react to everything. Sometimes even water, or a bedsheet brushing against their skin! But it's never been that bad for me, knock on wood.
Let's say that for my case of MCAS, I can handle 20 "histamine points" per day. If I assign each trigger a point value (so for me kombucha would be a 20 and a shower would be a 2) then I can predict how much I can handle. I never can handle a kombucha, and I usually can handle a shower. But on a day when I exercise (6) and am stressed out (6) and there's pollen in the air (3) and I eat a tomato salad with vinaigrette (5), a shower (2) would send me over my 20-point limit, and I'd react. Does that make sense? I just mean that MCAS sensitivity can be cumulative.
I think it is something to explore for you. I'd start fairly simply, with a strict low-histamine diet for a week (lots of lists online) and taking quercetin. It seems unlikely to be a revolution for your nerve pain, unfortunately, but it could be part of the puzzle for the rest of it.