Among the best treatment for patients with IBD is primary care, which guarantees a timely diagnosis, avoiding complications.
Dr. Stephanie Velázquez, fellow of the Gastroenterology program at the Medical Sciences Campus and Dr. Rafael Medina Prieto, fellow of Gastroenterology at the University of Puerto Rico. Photo: Journal of Medicine and Public Health/ Provided by the specialists.
Las Inflammatory Bowel Diseasesare those disorders that present chronic inflammation of the digestive tract, which involve the disease of Crohn and ulcerative colitis.
Faced with these diseases, there are some comorbidities that can exacerbate the symptoms, or that can allow some of the Inflammatory Bowel Diseases to develop more easily (EII) as they are:
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Smoker patients, with harmful habits towards their health.
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Age, since these conditions usually occur, usually in young people, or in people over 50 or 60 years old
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Symptoms can be complicated if they are patients on non-steroidal anti-inflammatory treatments.
Are there barriers in Puerto Rico for the treatment of these conditions?
Specialists have the education for primary care of these cases, they have the technology to develop diagnoses and, likewise, to establish treatments. But at the same time, several and complex barriers are created when it comes to accessing medications, or performing procedures, even at the time of diagnosis with tests and laboratories.
The biggest obstacle, and the first to appear, are the medical plans, “we have patients who need regular imaging, patients who in a year can have two, three, or four colonoscopies, or at least a short colonoscopy, and in the experience with the government plan, those are the limitations, we do know which images to do. We have the capable specialists, but that causes it to be postponed and that results in poor quality of life for the patient,” says Dr. Rafael Medina Prieto, a fellow at Gastroenterology from the University of Puerto Ricoin an exclusive interview with the Journal of Medicine and Public Health
The diagnostic process This type of disease requires a multidisciplinary work with a complete follow-up, from the symptomatological evaluation, to the search for treatment.
“The diagnosis of EII Unfortunately, there is no other condition that we can diagnose with a simple laboratory, it depends on images, endoscopic studies and laboratories, it is not as simple as doing a colonoscopy with biopsy, it is a conglomeration of many particularities of each patient,” says the specialist. Medina.
In addition to this, the need is created to extend the form of examination and evaluation of the patient, since some mechanisms used do not guarantee effectiveness in all cases, “sometimes biopsies do not necessarily give us that diagnosis, per se”, thus says Dr. Rafael Medina.
These conditions of intestinal inflammation, present with symptom such as “abdominal pain accompanied by bloody diarrhea, weight loss, or in cases where the patient’s situation is very complicated, with problems such as perforations, which may require surgery or medical interventions,” confirms Dr. Stephanie Velázquez, a fellow at Gastroenterology program of the Medical Sciences Campus.
to which there are various risk factor’ssuch as genetic aspects that can influence development, or patients who have autoimmune conditions, although it is not a determining factor, since patients can develop Crohn o Colitis, without the need to be immunocompromised.
In the search for new and better mechanisms of diagnosis and treatment“some genes have been identified, but none specific for the conditions of EIIone must wait as the studies come out, to be able to use a genetic study, either for diagnosis or treatment,” says Dr. Velázquez.
Do I have dietary restrictions if I suffer from IBD?
In general, patients with Ulcerative Colitis do not have nutritional restrictions, beyond a conscious diet. But if the patient is Crohnis facing a condition of narrow intestine for which metabolic development is limited, and it is necessary to have a restricted consumption of fiber, taking into account that having a narrowing problem, it can cause symptoms of intestinal obstruction.
Faced with patients who, in addition to a EII also suffer from conditions such as diabetes or hypertension, it should be borne in mind that their diet and lifestyle habits should be aimed at preventing exacerbation of the condition; Likewise, the treatment with this group of patients is aimed at reducing the risk of a metabolic syndrome, by “lowering sugars, avoiding these ultra-processed foods and avoiding soft drinks,” says Dr. Medina.
Where can I find help or services if I have these illnesses?
It is very important that patients have a close relationship with their primary care physician and this, in turn, develops all the laboratories and routine tests to complete their assessment scheme, which allows for comorbidities or pathologies such as those Inflammatory Bowel Diseases within their care to be on the radar. evaluation, always looking for the quality of the patient to guarantee a timely diagnosis.
“There are many aids to these patients, both through the association of the Esther A. Torres Foundation, which we always try to educate patients and doctors about this condition, if at any time the patient or the primary care physician identifies someone who may have these symptoms, we are always here to serve and evaluate them to help them in the best way, to make the diagnosis and start treatment, if necessary,” concludes Dr. Velázquez.
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