Taking on stomach problems: New center to help with digestion troubles

EL PASO -- People who had given up hope for an end to regular vomiting, stomach pain or trouble swallowing might again have hope for effective treatment locally.

Dr. Richard McCallum, a gastroenterologist and chairman of the Department of Internal Medicine at El Paso's new medical school, said the city soon would be home to the Center for Gastrointestinal Motility and Functional Bowel Disorders.

The center is a collaboration between University Medical Center of El Paso and Texas Tech University Health Sciences Center Paul L. Foster School of Medicine.

Launched Sunday, it will diagnose and treat patients who have problems digesting food.

"The biggest need for such a center is that typically the tests we do are the next level of tests," said McCallum, who previously ran a similar program at the University of Kansas Medical Center.

He said many doctors offer diagnostic tests such as endoscopies, biopsies and CT scans.

"After that's done they're fairly limited for what's available to them," he said.

Often, patients are sent to other cities for more advanced testing.

"We want to give physicians an opportunity to have another level of care here," McCallum said. "Rather than sending patients to the Mayo Clinic, we can take care of them right here."

Equipment is still arriving for the new center. It will test for symptoms such as nausea, indigestion, pain when eating, feeling full quickly, loose stools, constipation, trouble swallowing and chest pain not related to heart disease.

"We offer a very cutting-edge array of the best tests to diagnose the disorders," McCallum said.

Among them are the esophageal motility test, in which a special catheter that measures the muscles and pressure of the esophagus is swallowed; a gastric emptying test, in which a meal is consumed and then is monitored to see how quickly it leaves the stomach; and, similarly, ingesting a SmartPill capsule, a high-tech tool that measures the time it takes for the pill to travel to the stomach, to the intestine and to the colon, as well as recording pH, temperature and pressure measurements.

Doctors can also conduct a "gas test" to measure possible excessive bacteria-creating gas when a person eats; can measure the amount of ulcer-causing bacteria in a patient's stomach; and can conduct an anorectal motility test, which measures the function of a person's rectal muscles.

"These are an array of studies that are all in one place and can be done for a patient, and in four or five days or a week we could find out very quickly what is the problem," McCallum said. "Is it your esophagus? Somewhere between the esophagus and the rectum? Is it gas or the muscles in the rectal sphincter that won't let you function properly?"

He said patients from across the nation are likely to be referred to El Paso. He already has interest in patients from Kansas who knew of him when he worked there, as well as from Oklahoma and New Jersey.

"These are a series of tests the average hospital and (doctor's) office do not have," McCallum said.

In addition, doctors at the center will conduct medical studies for new drugs and treatments for various digestive problems.

The center is recruiting diabetic patients with gastroparesis to participate in a research study for a new drug.

Gastroparesis is a condition that develops after damage to the stomach's nerves, muscles or cells.

"Almost all the gastroparesis we see here is from diabetes," said Dr. Tamis Bright, an endocrinologist and associate professor of endocrinology at the medical school. "These are some of the sicker diabetics. ... (Diabetes) damages the blood vessels and nerves to the stomach so it can't function right."

She said people with the condition eat, and instead of their stomachs churning food and moving it to the small intestine, it stays in the stomach.

"These people get bloated and nauseated and eventually they just throw up," said Bright, an investigator on the study.

The 10-week study, which also is being conducted at about 10 other sites around the world, offers patients a drug to possibly speed up emptying of the stomach. The drug has shown positive outcomes in previous studies with intravenous delivery.

"We want to encourage anyone who has symptoms to come," said Dr. Irene Sarosiek, director of gastrointestinal motility and neurostimulation research at the medical school. "They may have no idea what's wrong with them. They have diabetes and they are vomiting and sometimes they think 'That's normal for me because I've been doing this for years.'

"We want them to know that it's not normal and we can help them."

The group hopes to recruit 10 to 20 patients to the study, who will receive the treatment free and will also receive a stipend for their participation.

McCallum said the center would also soon offer a last-

resort surgical option for patients with persistent nausea, including those with gastroparesis.

The gastric stimulator is similar to a pacemaker.

It is implanted into a person's abdomen and delivers electrical impulses through electrodes 12 times a minute to inhibit the brain's perception of nausea and prevent the person from vomiting, McCallum said.

Doctors will begin performing the procedure here in November.

"In baseball terms," McCallum said, "we're going to move from Triple-A into the big leagues now."

Erica Molina Johnson may be reached at emolina@elpasotimes. com; 546-6132.

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