Newspaper article St Louis Post-Dispatch (MO)

A Swallowing Problem Opens the Door to a New Surgery Technique

Newspaper article St Louis Post-Dispatch (MO)

A Swallowing Problem Opens the Door to a New Surgery Technique

Article excerpt

When Theresa Conley's digestive problems started last year, she had no inkling she'd be a part of opening the door to a new surgical technique.

Conley, 54, was diagnosed with a condition, achalasia. Food can't get into the stomach because a part of the esophagus closes, said Dr. Faris Murad, an interventional gastroenterologist and one of two physicians on Conley's case.

It's roughly the opposite of acid reflux, when stomach contents back up into the esophagus. At the entrance to the stomach, a sphincter muscle opens and closes to allow food to enter the stomach. Conley's had stopped working properly, failing to open a bit at first, then refusing to open at all by early this year.

But she didn't know that was a problem, other than, "I couldn't keep anything down," Conley said.

The condition began gradually last year, she said, with small episodes of regurgitation, nausea and even chest pain that mimicked symptoms of heart problems. Nothing helped relieve the condition.

Over time, she got sicker and lost weight some 87 pounds.

Conley, a runner, had to stop, because she was suffering from malnutrition.

Murad said the condition can make a person miserable. Food sits in the bottom of the esophagus, pretty much held there by gravity. If she reclines or tries to lie down, it flows back through the esophagus, which can make the condition appear to be acid reflux.

During an examination, her doctor found a thyroid problem. Surgery in May repaired the thyroid gland.

After the surgery, her physician said a CT scan "didn't look normal," she said. The physician referred her to the gastroenterology division at Washington University.

Earlier this year, doctors diagnosed achalasia, which can be difficult to diagnose because it's rare and has no known cause, including family history, Murad said.

The thyroid was unrelated to the digestive problem, she said. "It was an accidental find," Conley said.

Maybe one in 10,000 people develop achalasia, and it is treated by stretching the sphincter muscle with a balloon or performing laparoscopic surgery to fix the errant muscle.

But Marud and surgeon Dr. Michael Awad teamed to use a new surgical technique: natural orifice translumenal endoscopic surgery. …

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