December 21, 2012
Story by Greg Harris; photo by Paul Rotzinger
A diagnostic test that involves having a thin catheter inserted through the nose and down into the esophagus might cause some discomfort but, for Shane Gowans, it’s nothing compared to the heartburn he’s suffered for years.
Gowans, 38, recently underwent the test at the new Calgary Gut Motility Centre at Calgary’s South Health Campus (SHC). As a result, doctors learned that the valve from his esophagus to his stomach has a faulty seal.
“For me, this was a life-changer,” Gowans says of the state-of-the-art, 24-hour impedance test he underwent. “I had been thinking, ‘Am I crazy? Is the acid reflux as bad as I think it is?’ But it was off the scale and the doctors were all amazed I was able to put up with it for as long as I have.”
Fortunately for Gowans there is a surgical solution.
He is one of the first patients to be referred to the Gut Motility Centre, where individuals with disorders of the upper and lower gastrointestinal tract are getting prompt, leading-edge diagnosis and treatment since the clinic’s opening in the fall.
The centre offers state-of-the-art diagnostic technology for patients whose ailments range from gastroesophageal reflux disease (GERD) to irritable bowel syndrome (IBS).
“The patients we’re seeing at the Gut Motility Centre typically have symptoms that can be debilitating, yet aren’t serious enough for urgent care,” says Dr. Michelle Buresi, a gastroenterologist and one of the medical leads at the clinic.
“We’ll be taking referrals from family physicians and we’ll provide a level of diagnosis and care that is available at only a handful of other health care facilities in Canada.”
Motility refers to the automatic contractions that move food from the mouth to the stomach and on through the intestines.
Some estimates suggest as many as one in five Canadians live with IBS, which is characterized by symptoms such as abdominal pain, cramping, diarrhea, constipation, or alternating diarrhea and constipation. Patients with IBS represent up to 40 per cent of referrals to gastroenterologists.
GERD occurs when stomach acid splashes back into the esophagus and causes heartburn. It’s estimated almost one in four Canadians experience heartburn daily.
According to Dr. Michael Curley, one of the co-leads at the clinic, physicians have at their disposal some of the newest technology anywhere for assessing gastrointestinal disorders.
For example, with the 24-hour pH-impedance test, doctors are able to accurately detect the acid levels of contents that reflux from the stomach into the esophagus.
“Traditional pH studies only detect acid reflux, but non-acid or weakly acidic reflux may explain why many people have persistent symptoms despite acid-suppression therapy,” Curley says.
The clinic is also equipped with high-resolution manometry, which involves placement of a thin plastic catheter into the esophagus, then having the patient take sips of liquid. This can detect multiple muscle and nerve disorders of the esophagus, which may contribute to swallowing difficulties and reflux symptoms. Compared to traditional manometry, high-resolution manometry allows for more accurate detection and characterization of motility disorders, Curley says.
