Few gastroenterologists choose this area of super-specialisation, perhaps because it requires empathy, time and patience (qualities currently in short supply). On the other hand, the FGID, particularly irritable bowel syndrome (IBS), are at the bottom of the list. This is logical, given that it combines all the characteristics of modern society: technology, imaging and immediacy. Endoscopy is the favourite of the vast majority of these young specialists. Because of the number of patients? Their needs? The research prospects? Because it is the doctor's personal "hobby" or the environment in which they train? The truth is that there are areas of gastroenterology that are "very attractive" to young gastroenterologists, and others that are not so appealing (or even "disliked"). What is not very clear, at least in our understanding, is who decides to work in one area or another of gastroenterology, and how and why they do so 1. Furthermore, those who engage solely or primarily in gastroenterology have their preferences, sometimes with monographic consultations on certain diseases: inflammatory bowel disease (IBD), the pancreas, cancer of the digestive system, coeliac disease, functional gastrointestinal disorders (FGID), etc. They include the digestive system, which straddles both gastroenterology and hepatology, Thus, most specialists in this field take a greater interest in one category or the other: "the tract" or "the liver". This is the reason why medical specialties were developed. Human diseases are so numerous and so complex that it is impossible for a single person, however intelligent or dedicated they may be, to have all the necessary knowledge. But not all doctors are capable of caring for all patients adequately. To say that a doctor's job is to help patients is stating the obvious. ConclusiónĮn nuestra opinión, para disminuir este desequilibrio entre necesidades y recursos, humanos y materiales, en el SII es imprescindible realizar cambios drásticos tanto en los aspectos educativos, de habilidades de comunicación, de priorización de acuerdo con las demandas de los pacientes, y de recompensa (personal y social) de los médicos. Los médicos prefieren la EII y tienden a estigmatizar el SII. La relevancia pública no es muy diferente entre las dos entidades, aunque los pacientes con EII son más asociativos. La relevancia científica es mayor en la EII, con un número de publicaciones cuatro veces superior. La dedicación académica es más del doble para la EII, tanto en la universidad como en la formación MIR. El coste social es muy importante en ambos casos (ej.: absentismo del 21 y 18%) así como el económico, aunque muy superior en medicación para la EII. Ambas patologías alteran la calidad de vida, en muchos casos de forma semejante. La prevalencia es 10 veces superior en el SII, suponiendo hasta el 25% de las visitas del gastroenterólogo. Para ello se han analizado 7 áreas diferentes: 1. Revisar los diferentes factores que determinan (o deberían determinar) el interés de los gastroenterólogos por el SII, comparándolo con la enfermedad inflamatoria intestinal (EII). In our opinion, to reduce this imbalance between needs and resources, human and material, in IBS it is essential to make drastic changes both in educational aspects, communication skills, prioritization according to the demands of patients, and reward (personal and social) of physicians.Įn nuestra opinión existe un desequilibrio entre la relevancia del síndrome del intestino irritable (SII), y los medios que se le proporcionan. Doctors prefer IBD and tend to stigmatize IBS. Public relevance is not very different between the two entities, although IBD patients are more associative. Scientific relevance is greater in IBD, with a number of publications four times higher. Academic dedication is more than double for IBD, both in university and in MIR training. The social cost is very important in both cases (e.g.: absenteeism of 21 and 18%) as well as the economic cost, although much higher in medication for IBD. Both pathologies alter the quality of life, in many cases in a similar way. The prevalence is 10 times higher in IBS, which represents up to 25% of gastroenterologist visits. For this, 7 different areas have been analyzed: 1. To review the different factors that determine (or should determine) the interest of gastroenterologists in IBS, comparing it with inflammatory bowel disease (IBD). In our opinion there is an imbalance between the relevance of irritable bowel syndrome (IBS), and the resources that are provided.
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