The Best Ways to Manage Your Digestive Disorder
Some digestive disorders can be easily managed, others need regular checkups.
Certain digestive disorders can require only lifestyle or diet changes and minimal medication. Chronic digestive disorders will require regular checkups. Talk to your doctor about treatment options to avoid any long-term damage to your health.
Don’t forget your screenings!
Screenings save lives and can prevent cancer or help diagnose several chronic health conditions that can affect your quality of life. Don’t put off your screenings – they can help you maintain and manage your health!
Practice Good Health
A healthy diet, good hydration, managing stress, knowing your digestive triggers, and managing your treatment plan can help you maintain good health and prevent long-term complications. Work with your doctors to come up with a plan so you can better treat your digestive disorders.
Provider Spotlight
Leon P. McLean, M.D., Ph.D., M.P.H.
An important part of the team of doctors at Granite State Gastroenterology, Dr. Leon McLean also teaches at Dartmouth College’s Geisel School of Medicine as a Clinical Assistant Professor. A well-respected member of the medical community, he is also a member of the American Gastroenterological Association, the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy, and the Crohn’s and Colitis Foundation of America. Board-certified in gastroenterology, Dr. McLean has a special interest and advanced training in the care of patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis). If you’re looking for a doctor that keeps up with the latest in medicine, look no further than Dr. McLean! He has published multiple scientific and clinical articles, co-authored book chapters, and presented his research at several national meetings.
Interview with Dr. McLean
How long have you been practicing medicine and what made you choose the profession?
I have been practicing medicine since 2006 when I graduated from Tufts University School of Medicine, where I earned both a Doctor of Medicine (M.D.) and Master of Public Health (M.P.H.) degrees. I completed my post-graduate training in internal medicine and gastroenterology, with a focus in inflammatory bowel disease (IBD), at the University of Maryland School of Medicine. During this time, I completed a Doctor of Philosophy (Ph.D.) in molecular medicine, also at the University of Maryland School of Medicine, focusing on immune regulation and inflammation of the gastrointestinal tract.
My father died when I was young. I remember going back and forth to hospitals when I was in elementary school, while he was sick. This was my first real interaction with doctors and nurses, and it made an impression on me. As a high school student, I did well in science classes and thought about a career in medicine as early as 9th or 10th grade. But it wasn’t until after my first year of college that I decided that I would apply to medical school. I wanted to do something where I could use science to help people, and hopefully have a positive impact on their lives.
What led you to choose gastroenterology as your specialty?
I chose gastroenterology because it’s a unique field that really allows us as physicians to do a lot of different things. Most importantly, I get to develop long-term relationships with patients who have chronic conditions, particularly patients with IBD (Crohn’s disease and ulcerative colitis). It’s very rewarding to meet someone when they aren’t feeling well and be able to help them get better and feel completely healthy again. In addition, I like being able to “fix” things with my hands – in gastroenterology we get the chance to do this by doing procedures such as colonoscopy or upper endoscopy.
How do you approach diagnosis and treatment for your patients?
The most important thing in diagnosing and treating a patient is listening to the patient. There are many labs and tests we can order, or procedures we can perform, but the story the patient tells about his or her symptoms is the thing that really gives us the most important clues about what the diagnosis is. Once we figure that out, I like to have a conversation with each patient about what treatment options exist, and that allows us to come to a decision together about how to get things better.
What is something you wish all patients knew about their digestive health?
Two things. First, and I think this has gotten better in recent years, I wish all patients knew how preventable colon cancer is. Currently, colon cancer in the third leading cause of cancer-related deaths in the United States and the third most common cancer in men and women. Pre-cancerous polyps are very common, and I find these in about 50% of patients who undergo their first screening colonoscopy (the average pre-cancerous polyp detection rate in our state is about 25%). By removing these polyps, we prevent them from turning into cancer.
It is now recommended that patients at average risk (no family history, no symptoms) begin screening at age 45. Several screening options exist, but colonoscopy is the only one that allows us to diagnose colon cancer as well as precancerous polyps of any size, while giving us the ability to remove these polyps at the same time. Stool-based tests do exist but may only be positive for colon cancer or large polyps, and if these tests are positive patients need a colonoscopy to remove these lesions. In addition, there can be insurance implications if a colonoscopy is performed to evaluate a positive stool test, rather than as a preventative test.
Second, patients should not ignore symptoms. Colon cancer can develop even in otherwise young, healthy people and can be as minor as mild bleeding with bowel movements or mild anemia. These symptoms should not be ignored. Anyone with these symptoms should be seen by a gastroenterologist.
What are the most important preventative screenings in your specialty?
Colon cancer screening for the reasons indicated above. It is very important to have appropriate screening to minimize the risk of developing colon cancer. Patients who have a family history of colon or other cancers, or certain conditions such as Crohn’s disease or ulcerative colitis, may need to begin colonoscopy earlier than age 45.
How do you stay up to date on the latest in medical news and technology?
Staying up to date with all the advances in our field can be challenging. There is always new information coming out about medications, procedures, or ways to think about GI problems. There are several GI journals that I subscribe to, and I usually attend one or two national meetings each year.
In addition to the above, I run a monthly IBD lecture series at Catholic Medical Center in Manchester. Through this lecture series, we bring experts to our area to talk about different aspects of IBD care to local gastroenterologists, advanced practice providers, nurses, and other members of the health care team.
Outside of gastroenterology, what are your hobbies and interests?
My wife and I enjoy traveling, getting together with family, and day trips in the area. We’ve spent more time at home than usual, like everyone, in the past year or so with our 6-year-old Beagle who is our best friend, and our happy 18-month-old daughter.
What is your favorite part of working with the team at Granite State Gastro?
The best part about working at Granite State Gastroenterology is the people – the patients, our amazing, dedicated, and hard-working staff, and the people at all the facilities where we go to do our procedures (Surgical Center of New Hampshire, Parkland Medical Center, Bedford Ambulatory Surgery Center, and Androscoggin Valley Hospital). Each of us is part of a huge team, many of whom patients may not ever meet or see. But they all help us do the things we need to do to take care of the most important people in our group – our patients.
What is a capsule endoscopy?
A capsule endoscopy is a procedure where a pill-sized camera is swallowed so that images can be taken of the small intestine. The images are recorded and sent to another small device. The procedure allows your doctor to view images of the duodenum, jejunum, and ileum portions of the small intestine and can be used to detect polyps, ulcers, tumors, and inflammatory bowel disease.
To prepare for the procedure you will be asked to fast for twelve hours. You should also inform your doctor if you are currently taking any medications, if you have any allergies, if you have a swallowing disorder, if you have heart or lung disease, or if you have a pacemaker or defibrillator. The entire procedure will last approximately eight hours. After the procedure, you will meet with your doctor at a follow-up appointment to discuss the results.
Ask your doctor if a capsule endoscopy procedure can help treat or diagnose any of your digestive conditions.
Irritable Bowel Syndrome: Do you have IBS-D or IBS-C?
A disorder affecting the large intestine, irritable bowel syndrome (IBS) is a chronic condition that requires long-term management. While the condition does not affect the bowel tissue or increase the risk of colorectal cancer, irritable bowel syndrome can affect a patient’s quality of life. Symptoms of IBS can include abdominal cramping, pain, or bloating, as well as changes in the appearance and frequency of bowel movements. Patients may also notice an increase in gas and mucus in their stool. Patients should talk to their doctor if they are experiencing a change in bowel habits or any symptoms of IBS. Similar symptoms can also be related to several serious health conditions such as colorectal cancer, which should be ruled out as soon as possible.
While the exact cause of IBS is unknown, factors that may play a role in the development of the condition include severe infections, early life stress, changes in gut microbes, abnormalities in the nerves, and muscle contractions in the intestine. Triggers of IBS symptoms can include food and stress. Patients are more likely to develop IBS if they are young, female, have a family history of IBS, and a history of anxiety, depression, or other mental illnesses. If a patient experiences persistent abdominal pain, difficulty swallowing, unexplained vomiting, weight loss, diarrhea, rectal bleeding, or iron deficiency anemia, they should see a doctor as soon as possible.
IBS with Diarrhea and IBS with Constipation
There is more than one type of IBS and knowing what type the patient is experiencing can lead to better treatment outcomes. Irritable bowel syndrome with constipation is one of the more common types of IBS. Patients may be experiencing this type of irritable bowel syndrome if at least twenty-five percent of their stools are hard and lumpy. Patients with IBS-C will also experience fewer bowel movements. Another type of IBS, IBS-D, is irritable bowel syndrome with diarrhea. With IBD-D the patient will experience more than a quarter of stools that are loose, while less than a quarter will be hard and lumpy. They may also experience excessive gas.
If you are experiencing the symptoms of IBS, make an appointment with one of the specialists at Granite State Gastroenterology. They can help you manage this chronic condition and improve your health!