Beating digestive disease

By the time an ambulance delivered Jennifer Martin to UC Irvine Medical Center in late April 2009, the doctoral psychology student was rail thin, deathly pale and in constant pain from her latest flare-up of ulcerative colitis.

The 27-year-old Costa Mesa woman had been diagnosed in 2007 with the chronic and debilitating autoimmune disease that inflames the colon. But the medications that kept her symptoms at bay had stopped working. Unable to eat or digest food normally, she shed nearly 30 pounds in two months.

That’s when her doctor sent her to UC Irvine Medical Center, which has the only multidisciplinary comprehensive center in Orange County for patients with complex cases of inflammatory bowel disease.

“Jennifer weighed 82 pounds and was very sick when she arrived,” says Dr. Nimisha Parekh, director of UCI’s highly specialized Inflammatory Bowel Disease Program. “She was not responding to medications, and she was losing hope.”

The months of agony and wasting had taken their toll. “Jennifer wasn’t just small in stature, she was small in spirit when we first saw her,” recalls team member Dr. Steven Mills, a colorectal surgeon.

Now, after care from Parekh and Mills, she’s thriving and preparing to hang her psychologist’s shingle.

“It has been fantastic to see the transformation,” says Mills, who performed a series of mostly minimally invasive surgeries that left Martin with small scars and free of the humiliating need to be near a bathroom at all times. “She’s a different person – happy, with such boundless enthusiasm.”

About 1.4 million Americans suffer from inflammatory bowel disease – either ulcerative colitis or Crohn’s disease, which involves chronic inflammation of the intestines. IBD symptoms include diarrhea, blood in the stool, abdominal pain, bowel urgency and weight loss. Ulcerative colitis and Crohn’s disease are believed to be caused by the body’s immune system going into overdrive and damaging the intestinal tract lining. There is no cure, but these conditions can be controlled with medication.

IBD runs in families, and it tends to affect people who have other autoimmune diseases, including rheumatoid arthritis, which Martin has battled since childhood.

Medications that suppress immune response work well, but in Martin’s case, even the strongest drugs had become ineffective. Given the extensive ulceration and her lack of response to medications, Parekh and Mills recommended removing her damaged colon and, in a later surgery, creating a way for her to eliminate solid waste from her body.

Moreover, they said, the procedures could be done with the aid of a laparoscope, a slender tube inserted through small incisions, all without opening the abdominal cavity, thereby minimizing the chance of infection and shortening recovery time.

The thought of losing an organ overwhelmed Martin. She also knew the resulting internal scarring could make it hard to get pregnant. “I cried for three days,” she says. “My husband and I had just gotten married six months earlier, and I wanted to have kids.”

Martin eventually accepted the surgical option with reassurances from Parekh and Mills. They explained procedures to her and her family simple terms, answering every question directly. “Dr. Mills made me feel like it was going to be OK,” she says. “He said, ‘You’re going to have your life back, and it’s going to be good.’”

It has been better than good, reports Martin, now 28. She’s had some setbacks but was able to take walks with her husband Tony and Chihuahua-terrier mix within a few weeks of each surgery. Six months after her colon was removed, she was able to eat most foods, albeit in smaller quantities and more frequently. She tips the scales at 100 pounds and hits the gym several days a week to build muscle mass.

Martin also could count on help from the IBD program’s social worker and support group. UC Irvine’s IBD program is unique in addressing the emotional, psychological and social effects of the disease along with physical aspects.

She now plans to use her doctoral degree in psychology to help people cope with the mental toll exacted by IBD, arthritis and other chronic diseases.

“When you go through something like this, you learn not to take anything for granted – that every day is a gift,” Martin says. “I owe my life to these doctors.”