Stanford's GI pain program is not limited to a specific diagnosis,
Prasad said. "Part of the value in our collaboration with GI
physicians is that we pain specialists get to learn more about GI
disorders and new possibilities for patients for whom GI physicians
have done all they can,” Prasad said, "those people who might be
thinking, 'It will never get better' or 'It's all in my head.' We want
to offer them a pathway to help them recapture quality of
Some people may feel that going to a pain specialist is like giving
up, that a pain specialist will automatically prescribe
narcotics," Nguyen said. "What we in GI do with the pain
group is try very hard not to do narcotics, to try other
In fact, Prasad said, contemporary pain care, particularly that
offered at the Stanford Pain Management Center, integrates various
approaches: non-narcotic solutions (mind-body therapies, including
cognitive behavior therapy, hypnosis and meditation) to address the
psychological component of pain; physical rehabilitation, pharmacology
and new procedural treatments. Those new treatments are often focused
controlling activity in very specific areas of the nervous system.
Nguyen hopes that this formal collaboration will help "get
across the idea to GI physicians is that pain is a complex system, and
that the longer someone has pain, the harder it is to control and the
more psychological impact there will be," she said. "For
example, if you look at patients who come to me with chronic GI pain,
half of them will also be experiencing anxiety and depression because
of that pain. And we know that very common disorders like irritable
bowel syndrome are made worse by that anxiety and
Knowing what all the options are means Nguyen can get closer to her
goal of patient care. "The most rewarding part for me," she
said, "is when someone comes in like a train wreck and leaves,
maybe not perfect, but at least better."
She called the Stanford GI pain program unique, and something that
has enhanced her ability to make positive changes in her patients'
lives. "I've worked elsewhere and taken care of the same type of
patient, but with the interaction with the Pain Management Center, I
don't feel as though I'm alone."
The collaborative structure will not end with GI patients, Prasad
said. "We want to build more pathways between us and other fields
where pain can be difficult, such as gynecology and urology. A lot of
things we do in pain management are somewhat universal."
Korstad's condition has not gone away--unfortunately, treatments to
cure it are few. But her pain is less. She's been treated with a
series of injections that have successfully blocked activity in
certain nerve roots. "They've worked amazingly for my pain,"
she said. "My doctors told me they were like a control-alt-delete
to calm things down."