Incidence of IBD in Puerto Rico has increased, the most recurrent peaks occur at 18 and 30 years, according to the expert.
Dr. Leonardo Hormaza, pediatric gastroenterologist. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
Within the First conversation of health professionals aimed at patients with Inflammatory Bowel Diseases (IBD), Dr. Leonardo Hormaza, pediatric gastroenterologist and who is the current president of the Association of Pediatric Gastroenterology and Hepatology of Puerto Rico.
In Inflammatory Bowel Diseases (IBD) or (IBD for its acronym in English) compared to the pediatric stages, the symptomatology is stronger and recurrent than in adults, therefore, within Puerto Rico, mechanisms are established that help these children and adolescents in their coexistence in shared spaces such as schools.
The primary care physician support has become fundamental in the diagnostic process, by becoming familiar, due to the fact that there are currently a greater number of cases, according to Dr. Leonardo, “Thanks to spaces like this, the community is being promoted and supported; Parents themselves help in the diagnosis, educating people is important, because it is currently being seen more”
Whether it is Crohn’s or ulcerative colitis, there are two scenarios, one from the development of daily, annoying symptoms that affect the development of daily life; on the other hand, patients with regular symptoms who do not know or catalog their discomfort with this type of condition.
“The incidence of IBD-IBD is thought to have two peaks, one at 18 years and another at 30 years, but currently it usually occurs in younger patients, from infants, the smallest patient I have seen is 11 months “, says Dr. Leonardo Hormaza.
Crohn’s is often confused with rheumatological diseases, since it presents pain in the conjunctures as a determining factor in the diagnosis, when the rheumatic element is ruled out and having the other symptoms such as weight loss, abdominal pain and fever, it is possible to determine that it is an (IBD).
This condition, by affecting the entire digestive tract, can present associated pathologies in all its extension, therefore, “esophagitis, gastritis, Crohn’s enteritis or colitis“says Dr. Hormaza.
On the other hand, the symptomatology of ulcerative colitis is somewhat obvious, considering that the main symptom is blood in the stool, but there are different types of colitis in relation to the factors; “There are allergic colitis, colitis, infectious colitis, lymphocytic colitis.”
In the United States, feeding is not usually used as primary treatment, unlike the European continent, which implements this measure when they are in mild phases or at an initial point of diagnosis.
But it is important that the diet of these patients, being children, be cared for and advised by a nutritionist, since at the pharmaceutical level they are covered with high doses, and factors such as fiber can trigger symptoms that affect treatment; For this reason, a multidisciplinary follow-up is needed, including immunology, since it is currently being associated with damage or changes in the immune system of patients, all in order to impact the quality of life of these patients.
These pathologies, “In the long term, mainly in children, they end up in malnutrition and malnutrition, poor growth,” says Dr. Hormanz, one of the greatest challenges with these patients, especially in the adolescent stages, it is in their emotional and social development in the face of the condition, since being in a formative stage the impact it generates on their minds, bodies and interactions is limited.
The specialist states that “biological drugs are the strongest we have, they are linked to the inflammation cascade, applied to patients who do not respond to mild treatments” therapies that are implemented in two ways, when they start with the most strong and decrease as the patient improves; or they start with mild biologicals that increase depending on the condition of the disease, either of them, is implemented in order to avoid the use of steroids.
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