Freed From Debilitating Inflammatory Bowel Disease
Marissa Russo has been battling symptoms of inflammatory bowel disease for half her life. When a flare-up that lasted several months had her confined to bed and barely able to function, she turned to the expertise of Mayo Clinic for a new approach to treatment.
Fitness, nutrition and health are incredibly important to Marissa Russo. She’s been doing CrossFit for the past six years and is used to exercising five times a week. And Marissa has maintained that pace despite dealing with the symptoms of inflammatory bowel disease for nearly 20 years.
For a time, however, as her medical condition spiraled downward, Marissa’s ability to continue her active ways appeared to be in jeopardy. Then she turned to Mayo Clinic, where she found help from Michael Picco, M.D., Ph.D., chair of Gastroenterology and Hepatology and a specialist in inflammatory bowel disease at Mayo Clinic in Florida.
“Dr.
Picco and his team are the Cadillac of GI services. They do what it takes to
get you whatever tests you need,” Marissa says. “They are very quick
to respond, and they’re advocates for you. They make you feel like you’re their
number one priority from start to finish.”
Disturbing decline
Inflammatory bowel disease is an umbrella term that describes incurable disorders that involve chronic inflammation of the digestive tract. Ulcerative colitis and Crohn’s disease are the two main types. Marissa began experiencing symptoms of inflammatory bowel disease when she was in her early 20s.
“It all started when I was
about 22 years old,” Marissa says. “I couldn’t keep any weight on. Every
time I would eat something, I felt like I had to use the restroom immediately.”
When she started noticing blood in her stool, Marissa went to a gastroenterologist who diagnosed her with Crohn’s disease and began treatment by prescribing Marissa anti-inflammatory drugs, including corticosteroids and sulfasalazine. The medications, which she took for 10 years, improved her symptoms. But when she was approaching her 38th birthday, Marissa’s condition took a turn for the worse.
“My
symptoms were becoming more frequent and harder to put into remission,” Marissa
says. “I went from taking the drugs for two weeks to having to be on them
for four to six weeks. I would go six months without being able to get my
flare-ups under control.”
“(The bowel spasms) felt like birthing contractions, and I would literally see stars because I was in so much pain.”
Marissa Russo
Her
local doctor prescribed different medications. But none of them put Marissa’s
condition into remission, and they had significant side effects, including
severe nausea that made it hard for her to do her day-to-day activities.
Then
when she turned 39, Marissa began to experience the worst flare-up she’d ever
had. It started in November 2017 and lasted through February 2018. During that time,
Marissa was having 16 bowel movements a day.
“I
was passing blood coupled with tissue during my bowel movements. I also had severe
cramping from bowel spasms every 20 minutes,” Marissa says. “They
felt like birthing contractions, and I would literally see stars because I was
in so much pain.”
Too
weak to drive her two kids to school, Marissa had to enlist help from
neighbors, family and friends. Frustrated and in hopes of finding a solution,
Marissa did some research and tried home remedies. They helped somewhat, but
she remained in considerable pain. Marissa and her husband decided it was time
to get another medical opinion.
“My
doctor at the time wasn’t listening to me,” Marissa says. “So my
husband said, ‘We’re getting you to Mayo Clinic.'”
Promising treatment
Marissa
had a consult with Dr. Picco at Mayo
Clinic in Florida on Feb. 15, 2018. That appointment followed two weeks
of excruciating pain during which she lost 20 pounds.
“By
the end of 14 days, I went from looking healthy to looking emaciated,”
Marissa says. “The first thing that went through my mind was, ‘Am I going
to live through this?’ I thought there was a chance that I wasn’t going to make
it, and I was losing hope.”
To get a better understanding of Marissa’s condition, Dr. Picco ordered a colonoscopy. “There’s no one test to distinguish between ulcerative colitis, which involves only the colon, and Crohn’s, which can involve either the colon or both the colon and small intestine,” Dr. Picco says. “The colonoscopy showed that Mrs. Russo had a pattern of inflammation in the large intestine which made it difficult to determine if she had ulcerative colitis or Crohn’s disease. If it’s not absolutely clear, we treat the patient with medications that are effective for both.”
“It seemed like once (Dr. Picco) found out what was really going on, he immediately had a solution.”
Marissa Russo
Dr. Picco recommended Marissa undergo treatment with the medication infliximab, which is used to treat ulcerative colitis and Crohn’s. It involves three IV infusions over six weeks. Then if that is effective, the medication is given every eight weeks.
“I
felt so relieved to have an answer and feel like there was going to be a
solution to my problem,” Marissa says.
Dr.
Picco explained that Marissa would need to continue the medication as long as
it was well-tolerated and effective, and that at some point, it could stop
working because some people eventually develop antibodies to the drug. If that
happens, a higher dose, a shorter time between treatment or both can help
maintain the medication’s effectiveness.
Marissa’s
interactions with Dr. Picco kindled new optimism in her. “He listened. He
allowed my husband to share his concerns, and he explained things in a way that
we could understand,” Marissa says. “It seemed like once he found out
what was really going on, he immediately had a solution. He told me, ‘You will
get better.’ That’s all I needed to hear.”
Achieving remission
Marissa
began the treatment with infliximab the following week, and she saw immediate
results. “I went from having 20 to 30 spasms a day to having four to five
the day after the first infusion. A week later, I had no more spasms or blood
or tissue in my stool. It was a wonder drug,” Marissa says. “For the
first time in a long time, I felt like I was actually living.”
Marissa
continued to see Dr. Picco for follow-up appointments every two weeks for the
first six weeks of her treatment and then every four weeks for the following
two months. Results from a six-month follow-up colonoscopy in August 2018
showed there was little to no inflammation in Marissa’s digestive tract.
“For the first time in a long time, I felt like I was actually living.”
Marissa Russo
Around
that time, her husband, a Navy pilot, received orders to go to Japan. But
because of Marissa’s illness, they were denied medical clearance to go
overseas. “Dr. Picco wrote up additional information about my treatment,
and how he was a proponent for my family to go to Japan if the treatment could
be continued,” Marissa says. “We appealed, and were approved to go to
Japan in October.”
Marissa
and her family have been in Japan since January, and her medical condition has
remained stable. “I’ve been on this treatment for a year and a half, and
it’s still working for me,” Marissa says. “My hope is that it will
keep me in remission through next summer when my husband’s overseas tour ends.”
Relishing family life
In
addition to allowing her the freedom to travel, the treatment has made it
possible for Marissa to go back to the gym and return to her CrossFit routine.
“In
March 2018 I could no longer do a pullup. I couldn’t jump more than three
inches off the ground,” Marissa says. “In about 60 days from the start
of my infusions, I had 75% of my original strength. That was a pretty quick
turnaround.”
She’s also now able to do many of the things for and with her children that she was too weak to do because of her illness. “I’m most grateful that I’m able to function for my kids — that I’m able to be a mom the way I was before the flare-up,” Marissa says. “It’s wonderful to be able to lead our normal life as a family, which involves fitness and travel.”
For
Dr. Picco, helping people like Marissa who have inflammatory bowel disease live
the way they want to is the goal of the expert care he and his team provide. “We
offer the ability to have one place for care,” he says. “We do tests
to determine if treatment or medications need to be modified. And we’re well-versed
in all the medications and how to maximize their effectiveness. This is a very
complex disease that requires very specialized care, including appropriate management,
monitoring and follow-up.”
HELPFUL
LINKS
- Learn more about inflammatory bowel disease.
- Read about inflammatory bowel disease care at Mayo Clinic.
- Visit the Department of Gastroenterology and Hepatology.
- Connect with others talking about digestive health on Mayo Clinic Connect.
- Explore Mayo Clinic in Florida.
- Request an appointment.