The specialist longed to be a pathologist, but her desire to help led her to delve into the area of gastroenterology.
Dr. Esther Torres, director of the Center for Inflammatory Bowel Diseases-UPR and president of the Esther A. Torres Foundation for Inflammatory Bowel Diseases (FEAT). Photo: Journal of Medicine and Public Health. Fabiola Plaza.
The Dra. Esther Torresdirector of the center for inflammatory bowel diseases-UPR and president of the Esther A. Torres pro foundation inflammatory bowel diseases (FEAT) promotes the awareness campaign, together with Medicine and Public Health, regarding the inflammatory bowel diseases.
The world day of these conditions is May 19, so it joins this effort to support patients with Alzheimer’s disease. Crohn y ulcerous colitischronic conditions, with intestinal inflammation, which are not cured and whose cause is still unknown, seeking to positively impact the quality of life of these patients and enable them to lead a normal life.
Dr. Esther Torres is a gastroenterologist, professor of medicine at the Medical Sciences Campus, she studied medicine at the University of Puerto Ricodid his training in internal medicine at the Veterans Hospital and the specialty in gastroenterology in the combined program of the University of Puerto Rico with three hospitals (municipal hospital, veterans hospital and university hospital). At this time he directs the Research Unit of gastroenterology and the Center for Inflammatory Bowel Diseases at the University of Puerto Rico.
She remembers that, since she was little, she always said that she wanted to be a doctor, but she does not know precisely where this motivation came from. Her mother said that she first said that she wanted to be a teacher and it turns out that she did both, since she is a doctor and a teacher.
When she studied medicine, her first idea was to become a pathologist because at that time it seemed like a very interesting area, but everything changes with her work experience at the veterans hospital, where she meets the person who runs the area of gastroenterologywho was his boss that summer, became his professional mentor and gave him the opportunity to learn regarding the clinical part of gastroenterologyin addition to the approach with patients in this area allowed him to take another path opting to take internal medicine and then gastroenterology.
When he began the residency, the number of patients with inflammatory bowel diseases was very low, however, in his years of residency internship he treated two patients that had a great impact on him, both were women, with ulcerous colitis and both died and she understood that she had made the best decision to serve patients with those conditions, despite the fact that at that time it was believed that the disease of Crohn did not exist in Puerto Ricowell, it was considered to be a disease of the Nordic countries or the United States, but in those years of residence he saw the first case in a patient with a lesion in the small intestine, which they thought was a lymphoma, but at operating on it turned out to be disease Crohn. She was regarding a person who had never left Puerto Rico.
Then they begin to increase the number of cases, most with ulcerous colitisand because they are complicated patients and require coordination with other specialties because the disease manifests itself in other systems as well, they decided to group them in a special clinic, dedicated only to patients with inflammatory bowel diseases.
It started in the hospital, with a small group, then in outpatient clinics and started an interdisciplinary collaboration as a project to care for these patients and they created a direct hospital service, where gastroenterologists are the primary care physicians. Today they are the only integrated interdisciplinary center in Puerto Rico, with nutritionists, psychologists, nurses, pediatric gastroenterologists and other specialists such as dermatology, ophthalmology, gynecologists, rheumatologists, among others. Pharmacy specialists also come to give medication advice to patients.
When Esther started in the profession the number of patients was small, but the number of patients grew. Another change that they have observed is that they have seen children with these diseases and it is an increasing number of children with Crohn that they will be adults and will form a large group in the future. Diseases have also become more complicated, the number of patients requiring surgery has been increasing. Before there were no powerful tools to keep a patient stable and now there is a greater variety of medications to be able to treat. There are patients with such aggressive diseases that drugs do not work, so further development is needed.
Previously, there were no specific guidelines on nutrition either, now they know precise elements in diets that contain anti-inflammatory properties. Today it is known that there are elements in diets that favor good bacteria and others that favor bacteria that are not so good.
Comparative studies are being applied and this has confirmed that diet has an impact on the factors that predispose them to the disease, together with the genetic factor. It is thought that there are factors that lead them to develop the inflammatory process. Although they are studies, it is thought that modifying what these people eat might help them obtain a better response to treatment, maintain their well-being -once remission is reached- and, perhaps, in a few more years, to prevent them from getting sick.
His passion arose following knowing these conditions that today are his professional reason. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
Today they also know how important it is to manage the emotional state of these people, since the percentage of patients with anxiety and depression associated with the disease is significant, so it is something that must be addressed, given the connection between the brain and the gastrointestinal tract, so by improving this you also get a good response to medications. This has been a drastic change in recent years.
Dr. Esther maintains that it is difficult to identify a patient’s anecdote over so many years because they are all the inspiration for the work, they are called heroes because they really are: most of these patients develop the disease in adolescence or in young adulthood and must face the fact that the rest of their lives they will live with her. It’s amazing to see how these patients accept it and say “I have Crohnbut Crohn does not have me” and how they fight every day to prevent the disease from dominating them, are an incentive to continue betting on research.
It is not easy to obtain incidence and prevalence data on these conditions, despite the fact that studies have been carried out that have shown a significant increase in diseases over the years.
The call is to raise awareness of these conditions, as they are not as rare as you might imagine. Thinking regarding these conditions is important for patients who have persistent symptoms, such as abdominal pain, diarrhea, bleeding in the stool, a child that is not growing, among others that are warning symptoms. Earlier diagnosis and earlier treatment help to avoid complications in these conditions, therefore, awareness of this, both in the general public and in front-line doctors, is extremely important.
