DEAR MAYO CLINIC: I've had a sensitive stomach since I can remember. My life has been constantly inconvenienced by too many trips to the bathroom. My family thinks I have undiagnosed irritable bowel syndrome. I should have sought care sooner, but what can I do now to treat it? What causes IBS? What are its symptoms?

ANSWER: First off, you are not alone. Irritable bowel syndrome (IBS) is common and affects approximately 1 in 10 adults in the U.S. IBS is characterized by abdominal pain with disordered defecation (constipation, diarrhea or both). IBS can generally be easily treated with a combination of education, reassurance, diet and medications.

IBS is categorized as a disorder of gut-brain interaction. This means that the bidirectional pathway between the brain and the gut is overactive. Patients with IBS are more sensitive in their gut than other patients. IBS may develop due to genetic reasons or insults to the gastrointestinal (GI) tract including food poisoning, prior infections, surgeries, trauma and stressful life events. Stress can greatly affect the GI tract via the brain-gut axis. This can include physical, emotional or financial stress and other types.

The key symptom of IBS is abdominal pain, which would be present at least one day per week on average. In addition, patients have symptoms of disordered defecation, meaning constipation (going days without a bowel movement or straining during a bowel movement) or diarrhea (watery, loose and urgent bowel movements). Some patients have alternating constipation and diarrhea. Overriding symptoms for many patients include gas, bloating and distension, which means a visible or measurable increase in belly size. 

Patients often wonder when to see a healthcare professional. A diagnosis of IBS is based on:

• Unintentional weight loss
• New anemia
• Family history of IBS or colorectal cancer

It is important to note that for most patients, extensive testing is not required to make a diagnosis of IBS, but rather taking a careful history and performing a thoughtful physical exam while using the criteria above. Since IBS is a disorder of gut hypersensitivity and of the gut-brain axis, blood tests, X-rays, colonoscopies, CT scans and other tests generally do not reveal an underlying problem such as an ulcer or a blockage.

It is also important to note that the "best" therapy for IBS is very patient-independent. Every patient is a unique individual with different types and levels of symptoms: 

• Mild symptoms: Symptoms are somewhat bothersome but not intrusive.
• Moderate symptoms: Symptoms are affecting daily quality of life.
• Severe symptoms: You may have been to the emergency department because of your symptoms.

One of the exciting things in the field of gastroenterology is the recognition in the last 10 years that we have this very dynamic gut-brain connection, this bidirectional pathway. What that really means to a patient is that it's not just the standard prescription of over-the-counter medications for IBS with diarrhea or adding more fiber to help improve symptoms of constipation — it's using different therapies such as FDA-approved medications, behavioral therapy and diet to quiet down this hyperactive, extra-sensitive GI tract in either the brain or gut. This improves overall symptoms, especially that of abdominal pain, which is the cornerstone of the diagnosis of IBS. The future is exciting, and there is hope for you and many others. —Brian Lacy, M.D., Ph.D., Gastroenterology, Mayo Clinic, Jacksonville, Florida

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DEAR MAYO CLINIC: I'm hearing more about the exposome and the role of the environment on our health. Can you tell me more about how it is being studied? I'm worried about the future when I read about studies that show microplastics and chemicals accumulating in our environment. 

ANSWER: The Centers for Disease Control and Prevention defines the exposome as the measure of all environmental exposures, from prenatal stages through a person's lifetime, and how those exposures interact with genetic factors to affect health. The term is very inclusive. It includes, for example, diet; pollution; and natural substances, such as radiation. Everyone's exposome is unique.

I appreciate your concern about environmental exposures. The point I like to make is that not all exposures are harmful. Some exposures may protect us from disease. When we're talking about the exposome, it includes elements that are a risk for health, such as tobacco use, and elements protecting us from illness, such as access to green space.

Historically, researchers have studied some environmental exposures. Epidemiological studies in the past have told us that excessive alcohol use, for example, has an effect on the human body, and this relates to disease. We have also known that exposures to some bacteria cause disease, such as salmonella or tuberculosis.

But given that there are millions of different types of environmental exposures, better and more systematic studies are needed to understand what this means to our health. 

As a scientific field, the exposome explores exposures that have an effect on humans biology. For me, as a physician and researcher, I would like to know more about exposures that affect our genes, cells and organs, or, in other words, how exposures affect human biology. Your exposome is the environmental complement to your complete set of DNA, called your genome. 

Scientists have more recently realized that only about 15% of most disease risk can be attributed to genetic elements. So we are left with the question: What else contributes to disease? Families, of course, share not only genes but their environment. They live in the same household. And this is how exposome science started, to try to be able to assess environmental exposures. 

Over the last roughly 50 years, chemicals have been mass produced by humans. Decades ago, we couldn't measure chemicals in our bloodstream in a scalable and affordable way. So we used questionnaires to ask, "Do you smoke?" "Do you drink?" "Have you been exposed to pesticides?" We were looking for the outcomes of those exposures to human health. 

For example, in my laboratory, we were studying a rare liver disease called primary sclerosing cholangitis, and we asked a decade ago whether patients were exposed to pesticides, as well as other environmental elements. But the questionnaires didn't show a difference between healthy people and those with primary sclerosing cholangitis. 

Years later, when we could use blood tests to measure chemicals in the bloodstream, we found a significant difference in a specific pesticide present among primary sclerosing cholangitis patients compared with healthy people.

So, based on several studies, we now know that pesticides are in our food chain and in our bloodstream in small amounts, and we need to know how they affect human biology and disease.

Also, massive plastic production within the last 70 years also has created microparticles that can be found inside people's tissues. We need to study these exposures both in health and in diseases such as cancer, heart disease, stroke, respiratory illness and autoimmune disease.

Nevertheless, when we do studies, often we find chemicals that are more prevalent in healthy people compared to patients with diseases. Scientists are working to identify those elements associated with wellness or with a lack of disease because these substances may protect us from illness. For example, some studies have shown that drinking coffee may reduce risk of neurological disease or liver disease. We need to understand this in more depth for therapeutic opportunities.

Current methodologies enable us to measure the exposome better than before through blood, urine, saliva and hair. I envision that 10 years from now, if not earlier, we will have screens of exposures that we will measure in our bloodstream. That will become part of a person's care at some point in the future and help us guide lifestyle changes, prevention strategies and make diagnosis as well as treatment decisions for patients. — Konstantinos Lazaridis, M.D., Gastroenterology/Hepatology and Center for Individualized Medicine

Learn more about the exposome:

• Tomorrow’s Cure: How a lifetime of exposures impact health – exposome explained
• Researchers link environmental exposures to liver disease

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Growing mini-organs to find new treatments for complex disease

Mayo Clinic investigators are growing three-dimensional human intestines in a dish to track disease and find new cures for complex conditions such as inflammatory bowel disease. These mini-organs function like human intestines, with the ability to process metabolites that convert food into energy on a cellular level and secrete mucus that protects against bacteria. These 3D mini-intestines in a dish, known as "organoids," provide a unique platform for studying the intricacies of the human gut.

"We think this has the potential to revolutionize the way we approach disease research. We hope to save time and resources and avoid the development of therapies that fail upon translation into patients," says Charles Howe, Ph.D., who leads the Translational Neuroimmunology Lab. "Understanding which treatments show potential for success in human organoids could dramatically accelerate the rate of new therapies for patients with unmet needs."

Brain stimulation shows promise in treating drug addiction

Physicians use neurostimulation to treat a variety of human disorders, including Parkinson's disease, tremor, obsessive-compulsive disorder and Tourette syndrome. A Mayo Clinic neurosurgeon and his colleagues believe one form of that treatment, called deep brain stimulation (DBS), is poised to solve one of the most significant public health challenges: drug addiction.

"Drug addiction is a huge, unmet medical need," says Kendall Lee, M.D., Ph.D., who has published nearly 100 journal articles on DBS along with his colleagues. Key to treating it, he says, is cutting off the pleasurable "high" that comes with the addiction — which DBS potentially can do.

A new class of AI aims to improve cancer research and treatments

Mayo Clinic researchers have invented a new class of artificial intelligence (AI) algorithms called hypothesis-driven AI, which is a significant departure from traditional AI models that learn solely from data. The researchers note that this emerging class of AI offers an innovative way to use massive datasets to help discover the complex causes of diseases, such as cancer, and improve treatment strategies.

"This fosters a new era in designing targeted and informed AI algorithms to solve scientific questions, better understand diseases and guide individualized medicine," says co-inventor Hu Li, Ph.D., a Mayo Clinic systems biology and AI researcher. "It has the potential to uncover insights missed by conventional AI."

What's lurking in your body? Mayo probes health risks of tiny plastic particles

Similar to natural elements like iron and copper, people can ingest, absorb, or even inhale microplastics and nanoplastics and their chemical additives. A landmark study published in the New England Journal of Medicine links microplastics and nanoplastics found in plaques of human blood vessels to a potential increased risk of heart attack, stroke or death.

"Plastics have made our lives more convenient and spurred many medical advances, but we must understand their impact on human health for the years to come," says Konstantinos Lazaridis, M.D., the Carlson and Nelson Endowed Executive Director for Mayo Clinic's Center for Individualized Medicine.

Mayo Clinic researchers' new tool links Alzheimer's disease types to rate of cognitive decline

Mayo Clinic researchers have discovered a series of brain changes characterized by unique clinical features and immune cell behaviors using a new corticolimbic index tool for Alzheimer's disease, a leading cause of dementia. The tool categorizes Alzheimer's disease cases into three subtypes according to the location of brain changes and continues the team's prior work, demonstrating how these changes affect people differently. Uncovering the microscopic pathology of the disease can help researchers pinpoint biomarkers that may affect future treatments and patient care.

"Our team found striking demographic and clinical differences among sex, age at symptomatic onset and rate of cognitive decline," says Melissa Murray, Ph.D., a translational neuropathologist at Mayo Clinic.

Mayo scientists explore swabs for early endometrial, ovarian cancer detection

Early detection improves treatment outcomes for endometrial and ovarian cancers, yet far too often, women are diagnosed when in advanced stages of these diseases. Unlike many other cancers, there are no standard screenings for early detection of endometrial and ovarian cancers. Mayo Clinic researchers have uncovered specific microbial signatures linked to endometrial and ovarian cancers, and they are working toward developing innovative home swab tests for women to assess their susceptibility.

"This research not only brings us closer to understanding the microbial dynamics in cancer, but also holds the potential to transform early detection and treatment strategies to positively impact women's health globally," says Marina Walther-Antonio, Ph.D., an assistant professor of surgery leading this research.

Reversing racism's toll on heart health

People who experience chronic exposure to racism may be affected by factors such as intergenerational trauma, reduced access to healthcare, differential treatment in healthcare settings and psychological distress. These negatively affect heart health and can have a cumulative effect throughout a person's life. Researchers from Mayo Clinic and the University of Minnesota published a paper which provides a new framework describing how racism affects heart health among people of color in Minnesota. The researchers are focused on reversing these disparities.

"This framework will help scientists explore and measure how chronic exposure to racism, not race, influences health outcomes," says Sean Phelan, Ph.D., a Mayo Clinic health services researcher. "This will help enable researchers to design interventions that address the root causes of these disparities and improve heart health for people of color everywhere."

Teamwork and research play a key role in Mayo Clinic's first larynx transplant

A team of six surgeons and 20 support staff combined expertise from the Department of Otolaryngology and the Department of Transplantation in an extraordinary 21-hour operation at Mayo Clinic. The team transplanted a donor larynx to a 59-year-old patient with cancer whose damaged larynx hampered his ability to talk, swallow and breathe. This groundbreaking surgery was only the third larynx transplant in the U.S., and the world's first known successful total larynx transplant performed in a patient with an active cancer as part of a clinical trial.

"All transplants are complex, but there are more tissue types and moving parts with laryngeal transplantation than other transplants," says David Lott, M.D., lead surgeon. "Mayo Clinic's team science approach made it possible for us to offer this type of transplant on a scale that was previously unattainable."

Space: A new frontier for exploring stem cell therapy

Two Mayo Clinic researchers say that stem cells grown in microgravity aboard the International Space Station have unique qualities that could one day help accelerate new biotherapies and heal complex disease. The research analysis by Abba Zubair, M.D., Ph.D., a laboratory medicine expert and medical director for the Center for Regenerative Biotherapeutics at Mayo Clinic in Florida, and Fay Abdul Ghani, Mayo Clinic research technologist, finds microgravity can strengthen the regenerative potential of cells. 

"Studying stem cells in space has uncovered cell mechanisms that would otherwise be undetected or unknown within the presence of normal gravity," says Dr. Zubair. "That discovery indicates a broader scientific value to this research, including potential clinical applications."

Mayo Clinic’s largest-ever exome study offers blueprint for biomedical breakthroughs

Mayo Clinic's Center for Individualized Medicine has achieved a significant milestone with its Tapestry study. It generated Mayo's largest-ever collection of exome data, which includes genes that code for proteins—key to understanding health and disease.  

Researchers analyzed DNA from over 100,000 participants of diverse backgrounds, providing important insights into certain genetic predispositions to support personalized and proactive medical guidance.  "The implications of the Tapestry study are monumental," says Konstantinos Lazaridis, M.D., the Carlson and Nelson Endowed Executive Director for the Center for Individualized Medicine. "As this study continues to inform and transform the practice of personalized medicine, it also sets a new standard for how large-scale medical research can be conducted in an increasingly digital and decentralized world."   

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

Media contact:

• Colette Gallagher, Mayo Clinic Communications, newsbureau@mayo.edu

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DEAR MAYO CLINIC: I've had stomach issues my whole life, and it seems like my trips to the bathroom are becoming more frequent lately. I've heard of IBD. What is it? What are its symptoms? What can help me if I am diagnosed?

ANSWER: Inflammatory bowel disease (IBD) is a chronic inflammatory condition that usually impacts the gastrointestinal tract. IBD is an umbrella term for either ulcerative colitis or Crohn's disease, which are two different conditions with similar origins and inflammatory processes that affect the gastrointestinal tract. Ulcerative colitis involves inflammation along the superficial lining of the large intestine (colon) and rectum while Crohn's disease involves inflammation and ulcers that can involve the deeper layers of the digestive tract. This can affect anywhere from the mouth to the anus, but most commonly affects the last part of the small intestine and/or the colon.

Symptoms are variable and may sometimes be nonspecific, but the most common symptoms that patients experience are diarrhea, bloody stools and abdominal pain. Some patients might experience fatigue, fever, unintentional weight loss and joint pain. In some cases, patients develop extraintestinal (organs beyond the intestines) manifestations which can affect different organs in the body such as the eyes, skin, joints or liver.

Most people with IBD are diagnosed before their 30s, but some won't develop the disease until their 50s or older. To diagnose someone with IBD, a patient presents their symptoms to their primary care clinician or gastroenterologist, who takes a thorough history to try to better understand how long the symptoms have been going on. This would lead the healthcare professional to order further testing, which can include an endoscopic evaluation such as a colonoscopy. Biopsies taken during a colonoscopy are needed to confirm a diagnosis of inflammatory bowel disease. 

Currently, there is no cure for inflammatory bowel disease. However, there are many treatment options, including medical, surgical and dietary interventions that can help. The goal of treatment is remission, which means eliminating all the inflammation and getting back to what looks like a normal colon or intestine. The treatment options we use differ from patient to patient depending on the severity and location of the disease. The decision on treatment is shared between the healthcare team and the patient. 

Leaving inflammation untreated can lead to further complications. For example, if someone has persistent inflammation in their colon, that increases the risk for colon cancer. If someone has Crohn's disease, they're at increased risk of persistent inflammation causing something called strictures, which is narrowing in the colon or small intestine. Whenever there is a narrowing, it increases the risk of bowel obstruction, which would require surgery to help the bowels open up. This is why we are diligent in getting the right treatment to the patient and getting them to remission.

When it comes to IBD, diet is a question on everyone's mind. We do not have a specific diet for IBD, but we know that focusing on anti-inflammatory foods and antioxidants and avoiding processed foods, which can cause inflammation, is beneficial. One diet that I always recommend to most of my patients is the Mediterranean diet. The Mediterranean diet is a well-balanced diet that has a lot of anti-inflammatory products and antioxidants in it, so it could be very beneficial for patients who have IBD. Talk to your healthcare team about what is right for you. — Victor Chedid, M.D., Gastroenterology, Mayo Clinic, Rochester, Minnesota

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Dr. Lionel Kankeu Fonkoua, a Mayo Clinic Comprehensive Cancer Center oncologist, discusses prevention and treatment.

Watch: The Mayo Clinic Minute

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The most common form of primary liver cancer — cancer that starts in the liver — is called hepatocellular carcinoma. This type of cancer often develops in people with chronic liver diseases, such as hepatitis.

"It’s due to a chronic inflammation that leads to liver damage, cirrhosis and eventually to cancer," says Dr. Kankeu Fonkoua.

Most people don't have symptoms in the early stages of primary liver cancer. But when symptoms do appear, they may include:

• Yellowing of the eyes and skin.
• Unexpected weight loss.
• Upper abdominal pain.
• White, chalky stools.

Liver cancer treatments

Several promising treatments to manage the disease include targeted therapy and immunotherapy.

"Immunotherapy is kind of a novel type of cancer treatment that is designed to boost your immune system to attack the cancer," explains Dr. Kankeu Fonkoua.

Eating a balanced diet of fruits and vegetables, limiting alcohol consumption, and getting vaccinated against hepatitis B can reduce your risk of liver cancer.

"The hope is that we can trigger a tumor specific immune response for every patient,” says Dr. Kankeu Fonkoua.

Related Posts:

• Consumer Health: Liver cancer — risk factors and prevention
• Consumer Health: What do you know about liver cancer?

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Inflammatory bowel disease (IBD) is a chronic inflammation of the digestive tract. It includes conditions such as ulcerative colitis and Crohn's disease. People with IBD may experience persistent symptoms like frequent diarrhea, weight loss, abdominal pain and fatigue.

There is no cure and no exact cause, though researchers continue to look at how genes, the microbiome and environmental factors play a role in this chronic disease. Dr. Amanda Johnson, a Mayo Clinic gastroenterologist, helps explain IBD and whether diet can help.

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IBD is a broad term for chronic inflammation of your digestive tract. Two types are Crohn's disease and ulcerative colitis.

“Ulcerative colitis really tends to only involve the colon and be more of a superficial type inflammation; whereas Crohn's disease can impact anything in the intestine, essentially, from the mouth all the way down to the anus," says Dr. Johnson.

She says diet alone does not cause IBD. While some foods may reduce symptoms, there is no one proven diet to control inflammation.

"The right diet is probably different for each individual, based on the type of IBD that they have, the location of their disease, whether they've had surgeries or other complications," says Dr. Johnson.

Focus on fresh fruits and vegetables, and whole grains. Avoid ultraprocessed foods, added sugars and animal fats. And drink plenty of fluid to stay hydrated.

Diet does not replace medical treatment. Dr. Johnson says there are effective treatment options, so it is important to work with your healthcare team.

"The tenant of therapy we have are immune-suppressing-type therapies that try to target that inappropriate response to the intestines and then calm down that inflammation within the gut," she says.

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IBD is a chronic condition that causes inflammation in the digestive tract, but it can also affect other areas of the body. Crohn’s and Colitis (both classified as IBD) Awareness Week is observed each year from Dec. 1-7.

Dr. Victor Chedid, a Mayo Clinic gastroenterologist, explains what IBD is and how symptoms can be managed.

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People often associate IBD with the bathroom because of its symptoms, but it's a serious and chronic condition. There are two main types of IBD: Crohn's disease and ulcerative colitis.

"Ulcerative colitis only impacts the colon and causes inflammation in the entire colon, while Crohn's disease can impact anywhere from the mouth to the anus," says Dr. Chedid.

Patients often experience diarrhea, rectal bleeding, fatigue, weight loss, and stomach and joint pain.

"Some patients might develop what we call extraintestinal manifestations of their inflammatory bowel disease. And these can impact other organs. That means organs that are beyond the intestines," explains Dr. Chedid.

There is no cure and no exact cause for IBD, but there are medications to reduce inflammation. Also, watching what you eat can help alleviate some symptoms.

"We have to have a focus on diets that are high in anti-inflammatory foods and antioxidants, and low in foods that are processed that can be proinflammatory," says Dr. Chedid.

Treatments to manage inflammatory bowel disease

• Anti-inflammatory drugs
• Immune system suppressors
• Biologics
• Antibiotics
• Nutrition therapy
• Surgery

Related posts:

• Do you know the signs of IBD?
• Treating Crohn's disease and ulcerative colitis.
• Living with Crohn's disease and colitis.
• Can diet help with inflammatory bowel disease?

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Dr. Travis Grotz, a Mayo Clinic surgical oncologist, calls this an alarming trend and shares what people should know about the signs and symptoms of stomach cancer.

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"It used to be a cancer of old age, you know, 70s and 80s," says Dr. Grotz. "But now I'm seeing 20-, 30-, 40-year-old people with cancer."

He says many younger patients with stomach cancer are being diagnosed late — when treatment is less effective.

"I think unfortunately, the younger patients, they often think they had a bad meal. They think — even physicians, you know, think — that it's just reflux; they're just stressed out; they're too young to have cancer," says Dr. Grotz.

Symptoms of gastric cancer may be dismissed as minor issues in younger people. Those symptoms can include:

• Weight loss
• Reflux
• Indigestion
• Difficulty swallowing
• Anemia

"Reflux and having heartburn, indigestion, gastritis, that can be normal, absolutely," says Dr. Grotz. "But you certainly want to be aware of that and evaluate and make sure there's not something more sinister going on."

As for what's causing an increase in gastric cancer among younger people, Dr. Grotz says it could be a new, unknown risk factor, possibly related to food preparation or environmental factors.

Related post:

• Mayo Clinic Minute: New chemotherapy approach for treating stomach cancer

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The findings, published in the Journal of Clinical Investigation, open a new therapeutic avenue for treating pancreatitis by halting the breakdown of triglycerides.

"This discovery not only provides a deeper understanding of the mechanisms behind triglyceride-induced organ damage in pancreatitis but also offers a promising strategy to improve patient outcomes," says senior author Vijay Singh, M.D., a gastroenterologist at Mayo Clinic's campus in Scottsdale, Arizona.

Acute pancreatitis is a common gastrointestinal disorder that leads to approximately 275,000 hospital admissions annually in the U.S. alone.  An estimated 30% of patients with acute pancreatitis have a form of the disease marked by high levels of triglycerides.

Patients with hypertriglyceridemia-associated acute pancreatitis have a higher risk of persistent organ failure and severe pancreatitis, which often requires life support, prolongs hospitalization and increases mortality rates. Despite these severe outcomes, the mechanisms driving this form of acute pancreatitis have remained unclear until now.

In this study, the researchers analyzed triglyceride and fatty acid levels in blood samples from 269 patients with acute pancreatitis. They found that patients with very high triglycerides had more severe disease and higher levels of fatty acids.

In addition, they did experiments in preclinical models to see how metabolizing triglycerides into fatty acids affected organ health. In animals, this process led to organ failure, which could be prevented by blocking an enzyme called lipase, which plays a crucial role in triglyceride metabolism.

The finding could inform new ways to manage triglyceride elevation during pancreatitis. Current treatments, such as the use of the blood thinner heparin to reduce triglycerides, have shown minimal benefit in reducing organ damage or the severity of pancreatitis. Heparin works by breaking down triglycerides, but this process does not significantly improve patient outcomes.

Mayo Clinic researchers, led by Dr. Singh, are currently developing alternative therapies for acute pancreatitis that block the breakdown of triglycerides.

The recent study also sheds light on the implications of using heparin and other treatments that release the enzyme lipase. It found that the worst outcomes were observed in pancreatitis patients receiving nutrition via IV, as intravenous formulations containing triglycerides can be broken down to potentially harmful fatty acids by circulating lipases.  

The research team is now investigating the relevance of this finding in patients with elevated lipase levels due to other diseases, such as intestinal, heart and lung conditions. These diseases may silently damage the pancreas, causing it to leak lipase and create a vicious cycle of worsening organ damage.

"Preliminary studies suggest that patients with elevated triglycerides and lipase levels require more frequent admissions to the intensive care unit," says Dr. Singh. "If confirmed, these findings could point to new ways to prevent the progression of these diseases."

Review the paper for a complete list of authors, disclosures and funding.

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Donna Monroe, an accomplished interior designer and business owner, has always been passionate about music, travel and leading an active lifestyle. Her adventures with her husband have taken her to locations near and far, including on a recent trip that may not have been possible without a lifesaving diagnosis and surgery.

In August 2023, Donna underwent knee replacement surgery near her Delray Beach, Florida, home. An otherwise uneventful procedure came with complications weeks later. She began experiencing severe abdominal pain, which she initially attributed to medication side effects. When Donna’s condition worsened, she went to a local emergency department.

After five days in a local hospital, a CT scan showed a mass at the head of the pancreas, which physicians suspected to be pancreatic cancer. Concerned with this diagnosis, Donna sought a second opinion, which led her to Mayo Clinic in Jacksonville, Florida.

Dr. Yan Bi, a Mayo Clinic gastroenterologist, took charge of Donna's case. Dr. Bi ordered scans and labs to help understand what was causing Donna's symptoms.

"It was a Friday afternoon, almost time to call it a day, when I received an urgent call from Dr. Frank Chen," says Dr. Bi. "Dr. Chen alerted me to an emergency that couldn't wait."

"I remember trying to find lunch right after the appointment and receiving a call from Dr. Bi," says Donna. "Dr. Bi told me to return to the hospital immediately, so my husband turned the car around, and we went right back."

Test results revealed that Donna did not have cancer but an aneurysm at the tip of her pancreas that was dangerously close to rupturing. Her care team, including Dr. Jennifer Cowart, Dr. Gregory Frey, nurses, coordinators and others, sprang into action.

"Everyone handled the case expertly and prevented what could have been a catastrophic bleed," says Dr. Bi. "It is a testament to the incredible teamwork and rapid, patient-centered care at Mayo Clinic that ensures the best possible outcome for our patients when it matters most."

Donna remembers thinking after her surgery, "I was in good hands. Everyone was so kind, attentive and caring. Dr. Bi pushed me to get back to the hospital that day, and I'm not sure I'd be here without her."

Reflecting on the past year, Donna admits it was tough.

"It's taken a while to regain strength," she says. "When I look back, I feel much better."

Now, with her health improving, Donna is excited to travel again. She recently completed a journey to Switzerland — a symbol of her determination, made possible by the quick and compassionate care team.

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