The Patient Who Couldn’t Swallow

Marco Patti, MD

Imagine eating dinner one night and suddenly you can’t swallow—not just choking or needing to chew a little bit more, but literally not being able to get the food down. That’s what happened to Nick Metcalf, a 22-year-old student from the University of Iowa. He tells Reader’s Digest about what happened:

I hid what was going on from my friends, but I’m sure they wondered why I went to the bathroom five times a meal. I even had trouble swallowing water. Eventually, my whole diet was just peanut butter and honey sandwiches; for some reason, they were the only thing I could get down. I was six feet tall and dropped to 115 pounds—skin and bones—and I got very depressed.

Normal high school things became impossible. One day, I took a tiny sip of water on my way to class, and as soon as I sat down, I realized I had to throw up. I tried to leave, but my teacher chewed me out, so I just sat there fighting it down. I felt so humiliated and misunderstood. I was in the play Father of the Bride, and show week was horrible: On rehearsal nights, the parents would bring pizza, and I ate so little that some of the cast wondered if I had an eating disorder. I felt like I had no future because I’d always have this problem.

Nick was eventually referred to Dr. Marco Patti, professor of surgery and director of the Center for Esophageal Diseases at the University of Chicago Medicine, who diagnosed him with achalasia, a relatively rare disorder characterized by incomplete relaxation of the lower esophageal sphincter during swallowing and inability of the esophagus to contract. As a consequence, patients with the disorder experience dysphagia, regurgitation, chest pressure and heartburn.

Dr. Patti was able to fix this condition with a minimally invasive, laparoscopic surgery called a myotomy that makes small cuts through the muscle layers of the esophagus above the stomach, relaxing the opening to allow food to pass through. The next day, Nick was back to eating macaroni and cheese. Read more about his story and Dr. Patti’s work in this piece at uchospitals.edu that inspired the Reader’s Digest story.

About Matt Wood (468 Articles)
Matt Wood is a senior science writer for the University of Chicago Medicine and editor of the Science Life blog.
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