Digest This

Editor’s note: Jenny Tipton wrote “A Patient’s Perspective” in the August 2002 issue of EndoNurse , detailing her battles with lactose intolerance, ulcers, erosions throughout her stomach, severe GERD/acid reflux, and Crohn’s disease. Currently a student at Northern Arizona University majoring in chemistry, she shares the success she found that has literally given her a new life.

It has been just a couple of months and what a difference one minor procedure has made in my life. This procedure is called a Nissen fundoplication and it involves wrapping a section of the stomach around the lower esophagus, and then strengthening the muscular valve. This process improves the natural barrier between the stomach and the esophagus, preventing the backflow of acids and food from the stomach into the esophagus.

For the past five years I have been suffering from severe heartburn and acid reflux disease. I am only 20 years old so I have had these serious stomach problems for a quarter of my life! I knew something had to be very wrong with this picture — not only did I have these symptoms but I also have ulcers, Crohn’s disease, and other gastrointestinal problems.

Finding Dr. Nizar Ramzan of Colon and Digestive Health Specialists a few years ago changed my life forever. He got my Crohn’s into long periods of remission. Right now, I am doing infusion treatments of Remicade every other month. Remicade is monoclonal antibodybased therapy that has helped reduce my signs and symptoms. The treatment alone has induced and maintained me in longer periods of remission. Remicade is meant for patients with moderately to severely active Crohn’s disease who have had an inadequate response to conventional therapy. I am also taking Purinethol (also known as 6MP) once a day. The combination of these two has helped my stomach pains tremendously.

Once we had achieved getting my Crohn’s disease under control (for the most part), Dr. Ramzan and I could start concentrating on my upper GI. We knew we had to do something; I was taking Nexium twice a day, double the dosage, and still getting severe heartburn and reflux. I tried sleeping with my bed at a tilt, changing my diet, eating Tums like candy — everything you could think of and nothing worked. At this point I was even refluxing water! I thought I would live the rest of my life with these annoying and unhealthy symptoms. Even after knowing that I had all these symptoms, Dr. Ramzan did not want me to go through surgery unless it was absolutely necessary. So I went through one more test to determine if surgery was really a necessity.

This time I was actually looking forward to having an endoscopy. While I was undergoing the endoscopy, I had a camera attached onto my esophagus. This camera is called the Bravo and is manufactured by Medtronics, Inc. Since I had never heard of this device before, I decided to do some research on Medtronics Inc. My research showed that this wonderful company is committed to helping people live healthy and productive lives. They are a world leader in medical technology, so I had the utmost confidence that this process would benefit my life once the doctor found out more regarding my conditions.

The Bravo is a catheter-free alternative to monitoring pH levels in the esophagus, which uses a radio transmitter about the size of a vitamin capsule. This test has made pH monitoring much more tolerable than when I had the traditional nasal catheters in a previous treatment. The capsule was placed endoscopically on the wall of my lower esophagus; about two and a half inches up from my esophagogastric junction.

The camera then monitored my pH levels for the next 48 hours without inhibiting any movement — all the while transmitting data about my acid levels to a pager-like device that I wore like a purse. I was to monitor my food and beverage intake, and push a button if I was having heartburn, reflux, or chest pain. As you might guess, I was pushing these buttons quite a bit.

The next day I turned in my monitor along with the diary of food and beverage I had consumed over the previous 48 hours. The hospital downloaded information onto a computer for analysis. Within the next 14 days I was supposed to pass the capsule through my digestive tract, but mine came up out of my mouth that night. After calling the hospital, they assured me that I would be okay and the camera probably got dislodged in my system. My main concern was that they might not be able to get good results.

Well, the next day the results showed that I needed to have surgery. Right away Dr. Ramzan referred me to a surgeon, Dr. Bruce Freedman, who reviewed my results and agreed that I needed the surgery. I had to complete a couple of preoperation tests and then I was set and scheduled to undergo the laparoscopic surgery.

On Jan. 5, 2004 I had surgery, spent the night at the hospital, and was home the next day. My stomach was very sore for the next week or so. But now, four months later, I am feeling stronger, I have had no heartburn, no reflux, no Nexium or Tums, I watch what I eat but can have orange juice without problems!

By getting my Crohn’s into remission and having the fundoplication surgery, I now have to take only one pill per day along with my Remicade treatment. I owe these doctors the world. They have changed my life forever! I have more energy, feel better, and have gained my normal weight back, all thanks to incredible doctors and modern technology!