Jefferson Woman Overcomes Multiple Gastrointestinal Disorders

Shortly after Fiona Bishop started nursing school in 2023, every morning would start the same way with uncontrollable nausea and vomiting. Initially, the 18-year-old thought it was just first-year nerves or a routine stomach bug. But her primary care physician diagnosed her with a GI infection. 

When antibiotics didn’t clear the infection, her doctor referred her to a gastroenterologist who performed an endoscopy. That procedure, done toward the end of her freshman year, revealed that she had fluid and acid pooling in her stomach. A gastric emptying study confirmed the underlying condition, gastroparesis, a motility disorder that keeps the stomach from emptying efficiently. 

Over the next seven months, despite trying multiple different medications, Fiona had lost 50 pounds and was barely eating. “I could only tolerate mashed potatoes, gluten-free pasta and, occasionally, ice cream,” she recalls. “And when I did eat, I would get sharp stabbing pains and could only have small portions.”

Searching for Answers

Fiona’s gastroenterologist recognized that her condition required advanced specialty care. After seeing a dysautonomia specialist, she was referred to Douglas Weinstein, M.D., director of GI Motility at Jersey Shore University Medical Center. The first appointment was in January 2025.

“Dr. Weinstein sat with me for an hour and a half and just listened to me,” Fiona says. 

After comprehensive bloodwork and diagnostic tests, Dr. Weinstein recommended another endoscopy. He wanted to check the function of her pyloric sphincter, a muscle that controls how much food passes from the stomach to the small intestine. 

But that wasn’t the problem. So he implanted a temporary gastric stimulator, a device that uses an electrical signal to stimulate the stomach muscle and reduce nausea.

“This helped so much,” says Fiona. “I still had pain, but my nausea died down, I was able to eat more and I wasn’t vomiting as much.” 

Dr. Weinstein let Fiona know that during the endoscopy, he saw signs of compression in her small intestine, which indicated that she may have superior mesenteric artery (SMA) syndrome. This is a rare condition where the first part of the small intestine (the duodenum) gets pinched between two arteries, restricting the passage of food. 

A few days later, Dr. Weinstein confirmed the diagnosis with a CT angiogram and upper GI series. But because the surgery for SMA syndrome is quite invasive, he wanted to try more conservative treatment options first. 

Since the temporary gastric stimulator worked so well, Dr. Weinstein recommended she get a permanent one. He referred her to Seth Kipnis, M.D., a gastrointestinal surgeon at Jersey Shore. He did the procedure in April 2025.

This was the first collaboration in Fiona’s complicated case.

Discovering Another GI Issue

The permanent gastric stimulator helped Fiona eat better and keep food down. But she still wasn’t feeling 100%, so she consulted with Dr. Weinstein again, and he ordered a specialized ultrasound.

The ultrasound revealed another rare vascular-digestive condition: median arcuate ligament syndrome (MALS). In MALS, a tight fibrous band in the diaphragm acts like a kinked hose, compressing the celiac artery that delivers blood to the stomach, spleen and liver.  It was the reason she experienced severe pain when she ate. 

Fiona says that she had experienced pain in that part of her abdomen since she was 14 years old.

“When I was in high school, I remember feeling sharp pains in the rib area on my left side,” she says. “It felt like stabbing pain or the feeling of wearing a tight bra strap, but I attributed it to menstrual pain. It got worse when I played sports.”

Fiona was relieved to receive the MALS diagnosis. “I felt like I finally had an answer for why I had been feeling this way for so long,” she says. 

To help reduce the MALS pain, Fiona was booked for another surgery with Dr. Kipnis that July. This time, he worked with Alan Dietzek, M.D., a vascular surgeon at Jersey Shore University Medical Center, to perform a robotic MALS release and excision of celiac ganglion celiac plexus nerves.

During that surgery, the ligament compressing the artery was cut and the nerves were removed to help with the pain and, ultimately, fix the compression.

“I felt incredible afterwards,” Fiona says. “That pain I had had for six years was suddenly gone. I had never imagined that would be possible.”

Addressing SMA Syndrome

Fiona felt better for a few months, but at the beginning of her junior year, she started experiencing a different kind of pain.

“I would get pain 45 minutes after eating, and it would last four to six hours,” she says. In October, she got a feeding tube to help with the malnutrition.

By December, her feeding tube was draining bile, which indicated that her small intestine was backing up into her stomach.

“It was very frustrating,” she says. “We were at a loss for what to do. It felt like nothing was working.”

Her Jersey Shore University Medical care team stepped in immediately. Dr. Weinstein, Dr. Kipnis and Dr. Dietzek — who had been keeping in constant communication about Fiona’s care from the beginning — the team decided it was time to address Fiona’s SMA syndrome surgically. They suggested she consult with surgical oncologist Anthony Scholer, M.D., who performs complex abdominal surgeries on the duodenum at Jersey Shore.

After meeting with Dr. Scholer, Fiona felt hopeful that the surgery would help. 

In January 2026, she underwent a small bowel resection and a duodenojejunostomy, which cut her duodenum, the part of her small intestine where it was compressed. Dr. Scholer then released a ligament, removed her appendix, and rearranged her intestines, placing her small intestine on the right side of her abdomen and her colon on the left.

Learning to Live With a Chronic Condition

In the months since that surgery, Fiona says she’s been able to eat more and only uses her feeding tube at night.

“I can eat two meals, a snack and some dessert in small portions,” she says. “I was even able to have pizza last week, but, most important, I’ve learned I’m a lot stronger than I thought I was.”

In an inspiring full-circle moment, Fiona is using her lived experience to shape her nursing career. 

planning to specialize in nursing care for gastroenterology patients, and she’s leading the social media efforts for SMAS Research Awareness and Support, a nonprofit dedicated to educating others with this digestive condition.

“I’m in a much better place than I’ve been, and I’m forever grateful to this team,” says Fiona, who even gave her doctors matching T-shirts to commemorate their collaborative care. “Being chronically ill shows you who is there for you. I learned that my Hackensack team really was — and they’ll always remain so important to me.” 

Next Steps & Resources:

• Meet our sources: Douglas Weinstein, M.D., Seth Kipnis, M.D., Alan Dietzek, M.D., Anthony Scholer, M.D.
• Learn more about our gastroenterology services.