Joe Schena and his wife Cendy enjoy the Norma Pfriem Healing Garden at Park Avenue Medical Center before his post-operative appointment.

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When GI issues interfere with life

Joe Schena, 58, from Fair field, was in New Hampshire on business in late October 2016 when he experienced excruciating pain in his abdomen.

"It was the worst pain I had ever felt in my life," said Schena. "So two of my coworkers took me to the nearest emergency room."

His coworker contacted Schena's wife Cendy and explained that a surgeon would be calling her shortly. She was panicked when the surgeon explained that Schena had a full perforation in his large intestine and was being rushed into emergency surgery.

The surgeon removed a 10- to 12- cm piece of Schena's large intestine, formed a stoma, or opening, and attached a colostomy bag. Schena was discharged after several nights in the hospital and returned to Connecticut.

"A colostomy bag is used in cases like this so that the intestines can heal, so I had the bag for over three months," explained Schena. "November and December were rough, but luckily I could recuperate over the winter."

Almost four months later, it was time to have the colostomy reversed, so Schena's primary care physician referred him to Jorge Reguero Hernandez, MD, a Yale Medicine colorectal surgeon.

Dr. Reguero Hernandez made Schena comfortable from the start.

"He has a very easy going personality," said Schena. "He has a great bedside manner and that, combined with his expertise and knowledge, made the experience as pleasant and comforting as possible."

Schena underwent preoperative testing at Bridgeport Hospital and Park Avenue Medical Center in Trumbull. Then on February 8, he returned to Bridgeport Hospital to have the reconnection surgery. Schena's wife was updated throughout the surgery by Family Touch, a program that sends text messages to keep loved ones up-to-date. Schena was admitted for four days after his surgery and was complimentary of the entire team. "The staff was great, the nurses were wonderful," said Schena.

Schena is excited to get back into the swing of things, literally, on the golf course. "It has been over eight weeks since my reconnection surgery and I feel as good as new," exclaimed Schena. "As soon as Dr. Reguero Hernandez gives me the OK, I can get back to playing golf."

"It is a very exciting time to be a physician and a surgeon," said Dr. Reguero Hernandez. "With new techniques, we can offer patients an improvement in their quality of life. For patients like Joe, we are able to get him back to living."

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 60 to 70 million people are affected by a digestive disease, whether chronic or acute, like Schena's was. Bridgeport Hospital's team of physicians is specially trained to diagnose and treat these disorders of the esophagus, stomach, large bowel and small bowel, as well as the liver, gallbladder and pancreas.

"We have a team of physicians who are very good at what they do. The nursing staff is fantastic too," said Caroline Loeser, MD, section chief of gastroenterology. "In addition, we offer the latest therapies for most digestive issues so patients can get back to their life."

Gastrointestinal motility

Symptoms like bloating, constipation, diarrhea, heartburn, vomiting or difficulty swallowing may indicate a motility issue. The multidisciplinary team at Bridgeport Hospital, in conjunction with the Gastrointestinal Motility Program through Yale School of Medicine, offers the latest diagnostic and treatment services to patients with these hard-to-diagnose gastrointestinal disorders.

"When patients come to us, they are typically very frustrated. They have struggled for many years and haven't been able to  find relief. They may have bounced around a few physicians and may have exhausted their evaluations," said Mayra Sanchez, MD, director of the motility program.

Having a motility disorder can greatly affect a patient's quality of life, so getting the correct diagnosis and treatment is critical. Testing to help diagnose a motility disorder may include esophageal manometry, Bravo pH testing, hydrogen breath testing or SmartPill testing.

Bravo pH testing uses a small capsule to test acid levels. If there is a potential issue with the small bowel, a hydrogen breath test may be performed to detect sugar malabsorption or bacterial overgrowth. SmartPill testing, or a wireless capsule that allows a physician to identify abnormalities in intestinal transit, can also be performed.

"There are other facilities that provide motility services, but not with the experience we have. We do over 1,000 cases a year," explained Dr. Sanchez. "We have been doing this for eight years at Yale New Haven Hospital and we now offer this service at Bridgeport Hospital."

For new patient consultations and returning patients, Dr. Sanchez holds a motility clinic on the last Friday of every month at the Bridgeport Hospital MedEase outpatient clinic. Patients must be referred by their primary care physician or gastroenterologist to access motility services. Endoscopy services

Judith Mudre, 69, of Stratford, had lost 20 pounds in three weeks, was unable to eat and generally felt unwell. Her blood work was normal, so her primary care doctor sent her to Pietro Andres, MD, gastroenterologist at Bridgeport Hospital and Northeast Medical Group. He suggested Mudre have an upper endoscopy, a test that allows the doctor to look inside the esophagus, stomach and upper part of the small intestine.

"Upper endoscopies are used to rule out celiac disease, peptic ulcer disease, as well as complications of acid reflux. Colonoscopies are one of the best screening tests for a number of diseases, such as inflammatory bowel disease and colon cancer," said Dr. Andres. "Bridgeport Hospital offers services with compassion and skill that address every problem in the gastrointestinal tract, including diseases of the pancreas, biliary system and liver."

"I was feeling so badly, and Dr. Andres kept saying to me, 'We will figure this out and fix this,'" said Mudre. "He is the best doctor I have had in my entire life. He is so kind and compassionate. He even communicates with me by email through MyChart when I have a question or concern."

Due to the nature of her symptoms, Mudre wanted to have the test as soon as possible and was able to schedule her procedure at Bridgeport Hospital's outpatient facility, Park Avenue Medical Center, which in her words was "phenomenal." Fortunately, Mudre's endoscopy results were normal. Her symptoms were found to be caused by a hormonal issue and have been resolved.

When she is due for her next colonoscopy, Mudre will go back to either Bridgeport Hospital or Park Avenue Medical Center. "I had such a great experience at both places," she said.

According to the Centers for Disease Control and Prevention, regular screenings, such as high-sensitivity fecal occult blood testing, sigmoidoscopy or colonoscopy, should begin at age 50 for adults with no risk factors.

Patients with a family history of colorectal cancer should begin screenings earlier than age 50. Bridgeport Hospital's gastroenterologists can help decide which tests are best for a patient.

Liver disease

As many as one in four Connecticut residents suffer from liver disease. Liver disease can be inherited or from a variety of other factors, such as diabetes, obesity, alcohol or drug use or congenital defects. Patients may not experience symptoms like abdominal pain and swelling, chronic fatigue, dark urine, itchy skin, yellow-colored eye or skin tone or weight gain until their livers are severely damaged.

Proper care requires vigilance from healthcare providers like those at Bridgeport Hospital.

"Our team has a special focus on hepatitis C therapy, fatty liver disease and complications of cirrhosis, but we can diagnose and treat a range of liver diseases, including acute and chronic conditions," said Michael H. Nathanson, MD, PhD, hepatologist at Bridgeport Hospital and Yale Medicine.

Comprehensive liver services are offered at both Bridgeport Hospital and Park Avenue Medical Center. Testing such as imaging, blood work, liver cancer screening, autoantibodies or genetic screening through the Yale Clinical Genetics program will help Dr. Nathanson and his team tailor a treatment specific to a patient's condition.

Patients may call the Liver Services team at Bridgeport Hospital directly at 203-384-5077 to make an appointment.

Mudre and Schena are just two of the many patients who are feeling better and back on their feet, or back on the golf course in Schena's case, thanks to the gastroenterology team at Bridgeport Hospital.

For more information about the gastroenterology or digestive disorder services offered at Bridgeport Hospital, visit the digestive disorders section on the website .