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Monday, October 3, 2022

Main barriers that delay diagnosis and treatment of IBD

The best treatment for patients with IBD is primary care, which guarantees timely diagnosis to avoid 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 experts.

las inflammatory bowel diseaseare disorders that present chronic inflammation of the digestive tract, including disease Crohn’s and ulcerative colitis.

In the face of these diseases, there are some co-morbidities that may exacerbate symptoms, or that may allow certain inflammatory bowel diseases to develop more easily (EII) as they are:

  • Patients who smoke, with habits harmful to their health.

  • age, as these conditions occur more commonly, usually in younger people, or in people over the age of 50 or 60

  • Symptoms may be complicated if they are patients on non-steroidal anti-inflammatory treatment.

Are there barriers to treatment of these conditions in Puerto Rico?

Specialists have the education for primary care of these cases, they have the technology to develop diagnoses and, so on, to establish treatments. But at the same time, there are many more complex barriers to accessing drugs, or performing procedures, even when diagnosing with tests and laboratories.

The biggest obstacle, and the first visible, are medical plans, “we have patients who need routine imaging, patients who may undergo two, three or four colonoscopies a year, or at least A small colonoscopy, and government planning with experience, those are the limits, we know what images to do. We have competent specialists, but this causes it to be postponed and results in poor quality of life for the patient. is,” says Dr. Rafael Medina Prieto, a fellow in the University of Gastroenterology. Puerto RicoIn an exclusive interview with the Journal of Medicine and Public Health

diagnostic process This type of disease requires a multidisciplinary task with complete follow-up, from symptomatic assessment to treatment discovery.

“Diagnosis EII Unfortunately, there is no other condition that we can diagnose with a simple laboratory, it relies on images, endoscopic studies and laboratories, it is not as simple as doing a colonoscopy with biopsy, it is based on the many characteristics of each patient. The group is.” Experts say Medina.

In addition, the need to expand the form of examination and evaluation of the patient is created, as the use of certain mechanisms does not guarantee effectiveness in all cases, “sometimes biopsies do not necessarily give us the diagnosis, per se”. So says Dr Raphael Medina.

These conditions of inflammation of the intestines, present with Symptoms such as “abdominal pain with bloody diarrhea, weight loss, or in cases where the patient’s condition is very complex, accompanied by problems such as perforation, which may require surgery or medical intervention,” says a fellow of the gastroenterology program Confirms Dr. Stephanie Velazquez. Medical Sciences Complex.

in which there are various risksuch as genetic factors that may affect development, or patients who have autoimmune conditions, although this is not a determining factor, as patients may develop Crohn’s o Colitis, without the need to be immunized.

In search of new and better systems of diagnosis and treatment“Some genes have been identified, but none specific to the conditions of EIITo be able to use genetic studies, for diagnosis or treatment, one must wait for the study to appear,” Dr. Velázquez says.

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 Crohn’sNarrow bowel is experiencing conditions that require limited metabolic development, and limited consumption of fiber, bearing in mind that when a narrowing is a 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 high blood pressure, it should be kept in mind that their diet and lifestyle habits should aim at preventing the condition from progressing; Similarly, treatment with this group of patients aims to reduce the risk of metabolic syndrome by “reducing sugar, avoiding these ultra-processed foods, and avoiding soft drinks,” Dr. Medina says.

Where can I get help or services if I have these diseases?

It is very important that patients have a close relationship with their primary care physician and this, in turn, develops all laboratory and routine tests to carry out their evaluation plan, which are within their care of comorbidities or pathologies such as inflammation. Allows bowel disease. Evaluation be on the radar, always looking for patient quality to guarantee timely diagnosis.

“There are many aids available to these patients in collaboration with the Ester A Torres Foundation, which we always try to educate patients and doctors about the condition, if at any time the patient or primary care physician identifies someone with To help those who may have these symptoms, we are always in the best way to serve and evaluate them, to diagnose and initiate treatment, if necessary,” concludes Dr. Velázquez.

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