As part of our “Meet Yale Internal Medicine” series, today’s feature is on Mayra Sanchez, MD, assistant professor of medicine (digestive diseases) and director of Gastrointestinal Motility.
While a medical student in her native country of Cuba, Mayra Sanchez, MD, decided to emigrate to the US in 1996. Because of the different educational systems, she had to obtain a bachelor’s degree and a medical degree in the U.S. She completed her undergraduate and medical degrees, along with her residency training in Miami, Fla.
She considered many places for her gastroenterology (GI) fellowship training.
“One of the places where I interviewed was Yale,” explained Sanchez. “One of the things that I liked about Yale is that everyone is so friendly and collaborative.”
Originally, Sanchez wanted to become a hepatologist, and Yale has a strong reputation in liver diseases. During her training, she published six articles in this area, but during this time, she also developed an interest in motility disorders.
When Sanchez completed her fellowship, she initially worked in both general GI and hepatology as an attending physician at Yale New Haven Hospital (YNHH). But she found it satisfying to help patients with often-debilitating motility disorders, and has had a positive impact on a number of these patients referred to her by other gastroenterologists in the region. Therefore she decided to pursue her motility interests full-time.
Motility disorders, including achalasia and other swallowing problems, gastroparesis, severe constipation or diarrhea, small bowel bacterial overgrowth and others can affect the movement throughout the digestive system from the process of swallowing, to digestion and its eventual expulsion from the body. But a number of patients with these problems may also have psychological problems that relate to their gastrointestinal problems. Fascinated by this interaction and to better prepare herself to help these patients, she completed a two-year scholar program in psychoanalysis at the Western New England Psychoanalytic Institute. This experience marked a special turn in her career.
In 2011, she took over Yale’s Gastrointestinal Motility Program and, along with the colleagues she subsequently recruited, has grown the program exponentially from one provider, few patients and one motility lab to four providers, a research coordinator, many motility nurses and two motility labs in two different hospitals belonging to the Yale New Haven Health (YNHH and Bridgeport Hospital). Literally thousands of patients come from around New England and beyond to be treated by Sanchez and her team at these locations.
In addition to building a larger team, they are launching new technologies, procedures, research, education and collaborations across other sections in the Department of Internal Medicine and other departments within Yale School of Medicine to help these patients.
Due to the rarity and complexity of certain motility diseases, patients may be misdiagnosed or told that the symptoms are in their head. They may see as many as four or five physicians before being referred to Sanchez and her colleagues at Yale.
I think anyone with a prolonged condition that gives them nausea, vomiting, difficulty swallowing etc. can develop anxiety or depression from dealing with their disease. Helping cure them or treating their disease to make it more manageable helps them with their anxiety and depression. We can help these patients.
Dr. Mayra Sanchez
Sanchez understands the frustration that these patients can feel.
“I became interested in the association between mental health and functional disorders because many of these patients had doctors telling them that they cannot be helped or that their symptoms were in their mind and so they weren’t taken seriously. You can’t properly take care of these patients if you think that way,” said Sanchez. “I think anyone with a prolonged condition that gives them nausea, vomiting, difficulty swallowing etc. can develop anxiety or depression from dealing with their disease. Helping cure them or treating their disease to make it more manageable helps them with their anxiety and depression. We can help these patients.”
During the last few years, Sanchez and her colleagues in motility have worked to develop and expand Yale’s Gastrointestinal Motility Program. Now, they also are able to offer and perform cutting edge research; one currently open trial is for the use of domperidone to treat gastroparesis. Sanchez and her team also are studying the association between chronic cough or other respiratory disorders with esophageal motility disorders and gastroesophageal reflux disease (GERD), plus the effects of narcotics on esophageal motility disorders, and they are planning a trial for patients suffering from eosinophilic esophagitis. To learn more about ongoing or upcoming clinical trials, please contact Roman Ryabtsev, research coordinator.
The latest technology/procedure obtained by Sanchez and colleagues is the EndoFLIP® (endoluminal functional lumen imaging probe) to be used in the evaluation of motility disorders. Also, there are plans to collaborate with her advanced endoscopy collegues, to start using the endoscopically noninvasive surgical technique called peroral endoscopic myotomy or POEMS, in the treatment of achalasia.
Additionally, the program hosts continuing medical education courses on various motility topics.
Sanchez is excited about the growth of the program and its future.
“There are a lot of exciting things happening,” said Sanchez. “We are expanding into more advanced procedures, working on more exciting research projects and planning in the future to add even more providers. Currently, we are one of the busiest programs on the east coast. This has required a lot of patience and dedication by our team, but every year, we are improving and expanding our center. I am excited to see what else we can contribute to Yale and to the region and how we can further improve the quality of care of our patients.”
For more information on the Gastrointestinal Motility Program and the Section of Digestive Diseases, refer to Digestive Diseases.