NorthBay, Mayo Clinic Solve Medical Mystery

We’ve all experienced stomach pains — after a spicy meal or a stressful day — but when Jasmine Kaur’s sharp stomach pains persisted for more than a couple of months, even without a spicy diet, the Vacaville resident made an appointment to see her primary care doctor. The physician ordered some lab work to determine the exact cause of her stomach pain.

After tests returned with inconclusive results, Mounzer Al Samman, M.D. turned to the Mayo Clinic for a second opinion.

“They came back with elevated liver enzymes,” Jasmine explained. 

After running more tests, the physician referred her to Mounzer Al Samman, M.D., director of gastroenterology at NorthBay Healthcare.

“The exact cause of the elevated liver enzymes wasn’t immediately clear,” Dr. Al Samman said. “We needed an ultrasound of the liver to examine its structure, and some more lab work. We thought it was either fatty liver (non-alcoholic liver) or autoimmune hepatitis.”

“I was so nervous but Dr. Al Samman said not to worry, it would all be OK. He was very comforting and listened to each and every problem, asking me what are you feeling and for how long? He answered all my questions.”

Jasmine ultimately needed to have first an endoscopy to examine the structure of the liver, which was inconclusive, and then a liver biopsy. Jasmine was worried about the procedures. Would the endoscopy make her gag? Would the biopsy be uncomfortable?

“But they explained that I would not feel the endoscopy because I would be asleep, and that the biopsy would be just like a pinch,” the 31-year-old noted.

Both turned out to be true, Jasmine said, which proved to be a big relief. 

“The tests did not offer a clear-cut diagnosis,” Dr. Al Samman said. “I wanted a gastroenterology pathologist to give us an exact diagnosis, so I requested a second opinion from the Mayo Clinic Care Network.” 

Jasmine Kaur was relieved to learn her condition could be managed with diet and exercise.

NorthBay Healthcare has been collaborating with the Mayo Clinic Care Network since 2016, when NorthBay became the first Northern California organization to join the collaborative partnership. Through this arrangement, NorthBay physicians and their patients with complex medical questions are able to get answers from Mayo Clinic specialists without leaving home, and at no cost to the patient. 

“We sent Jasmine’s medical records and images to the Mayo Clinic, and a week later the Mayo pathologist confirmed fatty liver,” Dr. Al Samman explained.

The news was a tremendous relief to Jasmine, who was concerned that the alternative — an autoimmune disorder — would mean taking medicine for the rest of her life.

Jasmine started a low fat diet and aimed to lose weight. “I took it very seriously. I stopped eating fried and fast food, and ate a lot of vegetables and proteins,” she said. “I exercised two times a day.” Within six months she lost 15 pounds and her liver enzymes had returned to normal.

“Her prognosis is excellent,” Dr. Al Samman said. “With her weight loss, her enzymes are down. There is no scarring on the liver and she is doing really well.

“NorthBay’s relationship with Mayo Clinic Care Network is beneficial, especially for complicated patients,” Dr. Al Samman added. “Mayo is happy to help.” 


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