2023-04-17 12:30:33
Interview with Dr. Monserrate Largacha | 17 ABR 23
Specialist in Gastroenterology, current President of the Ecuadorian Society of Gastroenterology Manabí Chapter and member of the Organizing Committee of the “Regional Course of Gastroenterology and Advanced Endoscopy”
IntraMed interviewed the leading specialist in Gastroenterology in Ecuador: Dr. Monserrate Largacha. Their answers to our concerns cover the current panorama of some of the fundamental topics of the specialty.
Interview:
| What has been your professional career in medicine? |
I did my undergraduate studies at the Laica Eloy Alfaro de Manabí University; obtaining the title of Dr. in Medicine and Surgery; I worked as a resident doctor (the first woman) at the San Antonio Clinic in the city of Portoviejo; Residence at the Ecuadorian Institute of Digestive and Pelvic Diseases “IECED”; Head of Residents of the IESS Portoviejo Hospital and for the year 2014 I worked as a resident of the Internal Medicine and Infectious Diseases Service of the Rafael Rodríguez Zambrano Hospital in the city of Manta, in 2015 I moved to Mexico City to study the specialty of Gastroenterology by the National Autonomous University of Mexico at the Hospital Juárez de México; I completed a Fellowship at the Hospital Juárez of the SSA Center in Diagnostic Endoscopy in Mexico City-Mexico and finally I completed the residency in GASTRO-INTESTINAL MOTILITY; in the year 2018.
I have experience as an undergraduate university professor in the medical school of two universities in the country; Staff member of the Gastroenterology and Endoscopy service of the Hospital de Especialidades Portoviejo, of which I formed the Endoscopy Unit, and head of the Intestinal Motility Service and the Department of Teaching and Research Hospital Madre Teresa.
| What is the current situation of Gastroenterology in Ecuador? |
Undoubtedly, the exponential growth that has taken place in this specialty in terms of human talent trained inside and outside the country together with equipment and technology have allowed the existence of new centers and specialty clinics in the main cities of Ecuador in the last 3 years. . By population of inhabitants the gap would not be satisfied and this might improve if the doctors look for smaller provinces and in this way be able to reach all the inhabitants. There are centers in Ecuador with international prestige that provide training in subspecialties of our specialty to national and foreign doctors, which allows us to be seen as a specialty in avant-garde and innovation.
| What are the most prevalent pathologies? Those that are of concern from a health point of view? |
Gastroenterology is a specialty that deals with the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts, and liver. And we not only diagnose, but also assess and prevent non-communicable diseases that are alarming, not only in the country but worldwide, such as fatty liver disease associated with metabolic dysfunction “MAFLD”, an entity with increasing prevalence. Unlike other causes of chronic liver disease, MAFLD has progressively increased in frequency over the years; it is the leading cause of chronic liver disease in the world and is projected to be the leading cause of hepatocellular carcinoma.
The normal action (physiology) of the gastrointestinal organs, movement of material through the stomach and intestine (motility), digestion and absorption of nutrients in the body, cause situations such as lactose intolerance, or other foods; diarrhea, celiac disease and irritable bowel syndrome are one of the main causes of our consultation.
And if we talk regarding the upper digestive system, one of the main ones is gastroesophageal reflux disease, in addition to complications of acid peptic disease (bleeding gastric ulcers) and dyspepsia. Digestive system cancer is also worrying regarding the rising numbers that have occurred in recent years for cancer of the pancreas, colon, and biliary tract. Situation that might improve with better prevention strategies at the government level for the timely detection of these conditions.
| What were the reasons why you chose Gastroenterology? |
During the undergraduate degree in medicine, one looks for the profile of the specialty in which he considers a field of interest. This is an extensive specialty without question; Carrying out the assessments and learning how to evaluate the vast majority of patients with gastrointestinal complaints, whether or not it is the cause of their medical appointment or hospitalization, made me gain knowledge, since a wide range of patients are treated. of disorders and formulate recommendations to maintain health and prevent disease. There is another scenario, serious patients with situations that compromised their lives and seeing how they improved following starting their approach and diagnostic and therapeutic studies is what made me decide on this specialty.
A gastroenterology specialist is a trained physician with a unique combination of broad scientific knowledge, general internal medicine training, superior endoscopic skills, and the ability to integrate these elements to provide optimal health care to patients.
| How has the experience of the COVID19 pandemic been in your country? |
On Saturday, February 29, 2020, our first case was registered in Ecuador; then the National COE was activated for the coordination of the emergency; On March 11 of the same year, the WHO declared COVID-19 a global pandemic, and in Ecuador, through Ministerial Agreement No. 00126-2020, the State of Health Emergency was declared in the National Health System; with this the resolutions that were taken changed every week, or during the week. With Prohibitions for mobilization, airports were closed, not events with massive audiences, we had days to circulate, and those of us who might walk a little more freely, but due to work situations we were health personnel, armed forces, military, police and government agencies. Many deceased without suddenly not recognizing, cremation was an obligation at first, external consultations in health institutions closed, and countless situations that caused fear, ignorance, and concern to reduce fear in the face of how little we knew .
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