23-year-old Woman Gets Answers for Her Mystery GI Symptoms

January 28, 2025
In early 2023, Melanie Ferraz, then 23, began experiencing significant nausea after meals. At first, she chalked it up to allergies, which she had dealt with in the past, but the nausea and vomiting continued. Certain things would make her queasy, while others wouldn’t. As her condition worsened, even basic nutrition and hydration became challenging.
"I started getting severely dehydrated because even water wouldn't stay down,” Melanie says. “I lost an insane amount of weight, like a quarter of my body weight, in a matter of a few months."
GI Answers at Long Last
Social outings, family gatherings and even dating became sources of anxiety and embarrassment for her. "One Easter, we had a few friends and family over. I barely ate anything because I didn't want to excuse myself to the restroom every single time I ate something," she says.
In her search for answers, she kept a food diary, went to multiple doctors, took various tests and even had a colonoscopy. But no one could determine the cause. Finally, she met with Iman Andalib, M.D., gastroenterologist at JFK University Medical Center.
At their first meeting, Dr. Andalib, a specialist in esophageal disorders, performed a manometry, which is a test to see if the esophagus is contracting and relaxing properly. During the test, a tube is inserted through the nose and into the esophagus and muscle pressure is recorded.
The manometry results confirmed Dr. Andalib’s suspicions: Melanie had achalasia, a swallowing condition that affects the esophagus and makes it difficult for food and liquid to move to the stomach. The condition is very rare, occurring with an annual incidence of roughly one per 100,000 people. It does not predominantly affect a particular age, race or gender.
For Melanie, the diagnosis was both a revelation and a relief. "I remember almost crying when Dr. Andalib told me what my issue was. It isn't just psychological, because after a while, that's what we were thinking it might be,” she says.
Correcting Melanie’s Achalasia
“Every time we eat, the esophagus has to contract so the food goes down. Then once it reaches the end of the esophagus, it opens up and the food releases into the stomach,” Dr. Andalib says. “With achalasia, the esophagus is like cement. It's not really moving and there's no contraction. So as a result, the food stays in the esophagus and every time a person eats, the previous food is still there and has to come up. People with this condition are miserable.”
To correct Melanie’s achalasia, in May 2024, Dr. Andalib performed a peroral endoscopic myotomy (POEM), a minimally invasive surgery that involves cutting the muscle at the end of the esophagus to relieve the tightness, enabling food to pass into the stomach. Unlike traditional surgeries, POEM is performed endoscopically, meaning no external incisions and a quicker recovery time.
For Melanie, the relief was immediate and is ongoing. “Since the procedure, I've been gaining about a pound a week, and I have not had any sort of vomiting," she says. “Everything's been staying down, which is absolutely amazing.”
Her diet, like all patients who undergo the POEM procedure, began with consuming clear liquids after surgery. But by day seven, she could eat whatever she wanted.
Dr. Andalib told Melanie that her condition was likely something she was born with but didn’t show up until she was 25. Now that she’s been treated, it’s unlikely that her symptoms will return.
“From what Dr. Andalib has told me, the chances of anything like that coming back are minuscule. So I'm pretty darn sure I should be good,” Melanie says. “I'm really hoping so, too, because this is something I wouldn't even wish upon my worst enemy.”
Next Steps & Resources
- Meet our source: Iman Andalib, M.D.
- To make an appointment with a gastroenterologist near you, call 800-822-8905 or visit our website.
- Learn more about gastroenterology and nutrition at Hackensack Meridian Health.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.