Autobiography of a Button

Disclaimer - I will not be held responsible for any errors made in this post. My knowledge of anatomy, physiology, pathology etc. so far comes from listening to the few lectures in GI that i did attend. Any errors will be rectified and the story will be edited after I study the GI system properly.

The horror began when He spotted me sitting on the table. Peacefully seated beside several colleagues, i was enjoying an evening chit-chat when I was chosen from among them to embark on a journey of a lifetime. Before I realized what was happening, He picked me up between His thumb and fore-finger and popped me into His mouth! I screamed, I yelled but no one came to my rescue. If I had arms or legs I would have punched/kicked His incisors out!

Trapped in the buccal cavity, there was little I could do but pray. My future seemed bleak. I envisioned a horrible end to my meager life. I prayed that his molars and premolars wouldn't grind me. ("Dude, when was the last time you visited your dentist", i wanted to ask Him. He had more cavities than i could count!) I prayed that he would spit me out but He did the exact opposite. He swallowed me!

Into the dark, sinister depths of the oropharynx I went, only to be quickly forced downwards by peristaltic movements. The superior pharyngeus was religiously performing its duty. I guess this was proof that He did not have bulbar palsy or any other condition that could lead to a motility disorder.
I first banged on the aryepiglottic fold and I almost went into the piriform fossa (luckily, i was too big to be lodged in there). It was a tight squeeze through the pharyngo-esophageal sphincter and I’m sure He felt a lot of pain. Serves Him right! I would have loved to cause Him more pain but the stratified squamous epithelium was too abrasion-resistant. When i was almost at the cardio-esophageal junction I noticed some intestinal metaplasia in the lower part of His oesophagus. I hoped that He knew He had a case of Barretts oesophagus and that He was at risk of developing esophageal adenocarcinoma.

Down I went through the sphincter and into the stomach, only to get stuck between rugae near the greater curvature, just below the fundus. The fundic cells kept showering me with acid which corroded my glistening exterior. My color and my texture, my pride, my very reason to live! I lost them. There was no way they could survive a pH of 2. I screamed in pain as the acid burned through me. The rest of me survived the stomach because pepsin couldn’t digest me. Thank God I’m not made if protein! I stay here for hours, 4 to be precise, every second making my exterior dissolve more and more. I felt a sudden forceful contraction of all 3 layers of muscle, especially the ones in the pyloric region. I was whisked away towards the pyloric sphincter against which I banged with full force. This made me boomerang back to the pyloric antrum.

Another powerful wave of contraction and I was back at the sphincter and this time I was forced into the duodenum. Before I knew what was happening, I was shoved into what looked like a volcano about to erupt! I shut my eyes and said my final prayers. I fall headlong into this crater in the anterior duodenal wall. The smell of blood forces me to open my eyes and investigate. What I thought was an erupting volcano was actually a bleeding duodenal ulcer! I laugh at my own silliness. The margins of the ulcer were well delineated and were not heaped up or nodular so its safe to assume that it wasn't malignant. Thanks to peristalsis, I get out of the ulcer and move down through the duodenum. It felt better to be in here because I didn't get thrown around too much. I guess it’s always calmer inside a retroperitoneal organ. I pass the ampulla of Vater where I have my second shower for the day. This time it’s alkaline. My sore, acid-burnt body relish this splash of alkaline bile. It soothed my skin and I knew I should move away before it gets too alkaline and I get burnt all over again although I knew this wouldn’t happen for I had a generous coating of mucus from the numerous Brunner’s glands. Moving towards the duodeno-jejunal flexure, I hear loud noises coming from the Jejunum. It sounded like a rock concert was on! I got this urge to join the party but once inside the jejunum, I faced disappointment. There was no concert going on. It was just the Mesentery dancing away while absorption was going on at full scale in the villi. The villi with their brush border tickled me every time I knocked against them and even though they looked rather menacing at first I realized that were too focused on their absorptive duties to pay any attention to me. I moved through the jejunum into the ileum. With less villi, the interior looked less interesting. I saw a small opening looming up ahead. It was quite a fast ride through the coils of the ileum. I was at the ileo-cecal junction before I could gather my thoughts.

I entered into the rather spacious cecum and was careful not to enter the appendix. I had no intention of getting trapped in the vestigial organ, only to hope and pray that He would develop appendicitis and have an appendicectomy so that I could once again see the light of day. There was no way that I would condemn myself to an equivalent of life in prison. What if he never gets an appendicectomy! Life in the caecum was rather boring. There were some interesting polyps in the walls of the caecum but I paid little attention to them as they were few in number. Things got interesting when I started my ascent through the ascending colon. The number of polyps increased a hundred fold! It was like walking on a carpeted floor with funky designs on it. I knew that an undetected case of Familial Adenomatous Polyposis like this was dangerous. He needs a total colectomy and He needs it fast! I pity Him.

The water around me started disappearing and all movement slowed down. I had to wait for 90 minutes for a Migrating Motor Complex to arrive so that we could continue on our trek through the transverse colon. Following hours of wait and boredom, I finally began my descent through the descending colon and into the sigmoid colon where my patience was tested to the limit. I wait for over 48 hours here! With no TV or any other form of entertainment, deprived from my daily doses of Sean Paul music, life was a living nightmare.

I breathed a sigh of relief when I was pushed into the rectum, for I knew it was only a matter of time before I could breathe fresh air again. I traveled down the anal canal, banging on the anal valves and the columns of Morgagni, past the pectinate line and finally to the sphincter. I felt the internal sphincter relax but the external one was still contracted. I waited, cursing him for not letting me out. It relaxed, finally. Almost out! 2 seconds more to reach the exterior. Fresh air, at last! I’m at peace.