Introducing Dr. Neil Galletly, BJU's New Gastroenterologist
Welcome to Beijing! What brings you to China?
A big driver is family. My wife is from China originally, so our two kids have Chinese heritage. We’ve always said it would be fantastic to try to live in a Chinese-speaking part of Asia for a few years, both so they could learn the language and also so they could understand that part of their heritage. About a year ago there was an email advertising this post as a gastroenterologist in Beijing and I thought, “Amazing! This is just completely the right time.” Our oldest is four and our youngest is two, so they’re pretty portable at this age, and also hopefully it’ll be easier for them to soak up languages at this age.
But it’s also such an exciting time to be in China. There are so many changes going on. I think particularly healthcare is due for a real boom, and I think it’s exciting to be here during that time.
And of course being in Beijing, it’s the center of everything. It’s got this combination of centuries-old tradition plus rapidly changing modernity, so it’s an exciting place to be.
Tell us a bit about your background in Gastroenterology.
When I was at medical school and doing my internship, the thought of spending all day talking to people about their bowels and such made me think, “Absolutely no way!” I wanted to be a brain surgeon or heart specialist or something like that. But during my residency, I did a rotation in gastroenterology and I absolutely loved it. I loved the fact that you can spend time both in clinics talking to patients and getting to know them to understand their problems, but also you got to spend time doing endoscopy, where we look with cameras into people’s stomachs and intestines and so on. We do that both to find out what’s wrong and also to try and fix things. So, it’s a combination of skills needed. There’s also a lot of detective work in gastroenterology to figure out what’s going on and that makes it really challenging and fun.
I did my specialty training in gastroenterology in various London hospitals. I was fortunate enough to work in several centers of excellence such as Hammersmith Hospital and St. Mark’s Hospital, and also a couple of very good teaching hospitals such as Charring Cross Hospital. During my training in gastroenterology, I learned from a whole bunch of great gastroenterologists, liver specialists, endoscopists, and world-famous people. The training in gastroenterology in the UK typically takes five years, but I also took some time out from that. I spent a few years doing a research project at Imperial College, London on early detection of gastrointestinal (GI) cancer and was able to present the result to a number of international meetings.
Following completion of training, I became a consultant (like an attending) at Kingston Hospital, which is in southwest London, and also St. George’s Hospital, which is a teaching hospital in London. I was at Kingston for just over 10 years. During my time there, I was clinical director of gastroenterology and endoscopy and specialty lead in endoscopy and GI cancer and so on. I had also built up a relatively busy private practice there, and it was a lot of fun! I learned a lot of things and had some amazing colleagues and great patients, but after 10-11 years or so, it was time for a change in career, and so I’m here.
Tell us a little bit about how you became a fellow of the Royal College of Physicians.
The Royal College of Physicians in London is a British professional body dedicated to improving practice in medicine. It was founded in 1518, so it’s 500 years old this year. Fellowship of the Royal College of Physicians is an honor bestowed after election by the college as a mark of achievement and skill as a doctor and recognition of ongoing contribution to the profession. When you get elected as a fellow, you get an amazing fancy certificate, which, given the age of the college, is appropriately all in Latin. This year, I was also fortunate enough to gain recognition from the American College of Gastroenterology when I was elected a fellow.
Are there any specific areas within the field of gastroenterology that you specialize in?
Because I used to work in very busy general clinics, you could see one patient maybe with tummy pain and the next patient with a history of bowel cancer, the next patient with blood tests showing that there we problems in the liver. So, as a result of that, I’ve kind of developed expertise in a wide range of gastroenterology and hepatology. I suppose, certainly at Kingston, one of my areas of interest was endoscopy – and particularly therapeutic endoscopy (where you end up doing something rather than just taking a look for diagnosis) and ERCP, which is a special type of endoscopy where you look into the bile ducts. For example, if someone gets a blocked bile duct from a gallstone or a growth there that might cause them to become jaundiced, you can do an ERCP procedure to try to relieve the jaundice.
As I spend more and more time in gastroenterology, I’m also more and more enthused about going back to basics, being able to talk to people, relate to people, and put them at ease. Talking about your bowels, your poo – you don’t even talk about that with your family, so it’s really difficult to talk to strangers about that. So, it’s being able to develop a rapport with patients, put them at ease, and also being able to educate people and being able to reduce their risk of GI diseases.
You mentioned seeing patients with liver problems. Is that also something you specialize in?
Gastroenterology focuses on the digestive system and its disorders. You can think of not only luminal gastroenterology – your stomach, your esophagus, your intestine, and your colon – but also your liver, your pancreas, and your bile ducts as having an important role in digestion. The study of hepatology, which encompasses the study of the pancreas, the liver, and the biliary tree, is a subspecialty area of gastroenterology. In the UK, you can’t specialize in gastroenterology without training in the liver as well.
Who should be going to the gastroenterologist?
If you do have any concerns or symptoms related to digestion or acidity or bowel function, or tummy pain for that matter, particularly if there have been recent changes in symptoms, then I think it would be good to go see a gastroenterologist. Other things, like anemia due to low iron, can be a sign of GI issues because of blood loss into the gut, so it’s sensible to see a gastroenterologist there to get it checked out. For liver issues, it’s more difficult because the vast majority of liver conditions you don’t know about. If you have any concerns about your liver, or if you’ve done any recent blood checks or health checks and they’ve flagged up a concern on your liver, then it makes sense to see your gastroenterology or hepatology specialist.
If you have a chronic (long-term) GI or liver disease, then it’s usually sensible to be on a regular follow up with a gastroenterologist. If you’ve got a family history of stomach cancer or bowel cancer, it’s sensible to have a chat and talk about the importance of screening (endoscopies or colonoscopies). I think if you’ve got a history of pre-cancerous conditions like bowel polyps or something called Barrett’s esophagus, which is basically where you get acid irritations at the bottom of the gullet, then you basically need to be on regular review with a gastroenterologist.
Do you have any tips for patients who wish to avoid gastrointestinal diseases?
Prevention is so much better than cure and part of our job should be helping educate and prevent disease. So, what’s important? The obvious common-sense things like looking after yourself, eating sensibly, taking regular exercise, and drinking alcohol in moderation. You don’t have to be puritanical about all this stuff, but you just have to do things in moderation. On the English BJU WeChat, there’s some great dietary advice and I think that looking at that would be really helpful for patients.
Educate yourself right now!
Patients should also listen to what their body’s telling them. If they do need to see a gastroenterologist, don’t be embarrassed about it! Nobody likes talking about that sort of stuff but the whole waiting room is full of people waiting to talk about that stuff and that’s what we talk about – and we can improve things.
The final bit of advice is about making sure that there’s time in your day for yourself. That’s because a lot of GI problems can be made worse by stress. I’m not saying that stress causes them, but stress can make symptoms worse. We all have such hectic lives that we don’t have time for ourselves. Just being able to take five or 10 minutes each day of your time just to reconnect with yourself can help a lot with any stress symptoms that manifest themselves in the abdomen. The other important thing is making time each day for listening to your bowels and going to the toilet. We can make GI problems and symptoms worse just by ignoring it and rushing around and not having time to sit down and go for a poo.
Dr. Neil Galletly is BJU’s new Gastroenterologist! To make an appointment with him, please call the Service Center at 4008-919191.