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Dr. Leybelis Padilla, MD FACG

@leybelismd

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Holistic GI doc | 4M Method 🇵🇷
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You’re looking for colon cancer clues in the toilet… but what if the clue is on your skin? 👀

This one shocked a LOT of people.

And I would love for my dermatology colleagues to weigh in on this one.

Welcome to Things That Make a Gastroenterologist Look Twice: Colon Cancer Edition.

👀 Follow along for the clues you shouldn’t ignore.

*all of these images are not of my patient; representative images

References:
Lindelöf B, Sigurgeirsson B, Melander S. Seborrheic keratoses and cancer. J Am Acad Dermatol. 1992 Jun;26(6):947-50. doi: 10.1016/0190-9622(92)70139-7. PMID: 1535080.

Schwartz RA. Sign of Leser-Trélat. J Am Acad Dermatol. 1996 Jul;35(1):88-95. doi: 10.1016/S0190-9622(96)90502-2. PMID: 8682971.

Thiers BH, Sahn RE, Callen JP. Cutaneous manifestations of internal malignancy. CA Cancer J Clin. 2009 Mar-Apr;59(2):73-98. doi: 10.3322/caac.20005. Epub 2009 Mar 3. PMID: 19258446.

Ponti G, Luppi G, Losi L, Giannetti A, Seidenari S. Leser-Trélat syndrome in patients affected by six multiple metachronous primitive cancers. J Hematol Oncol. 2010 Jan 11;3:2. doi: 10.1186/1756-8722-3-2. PMID: 20064244; PMCID: PMC2820021. by @leybelismd

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2 months ago

3 years ago, I made the decision to quit working a traditional job at a hospital. I had been working for more than six years at the Naval Hospital in San Diego as a Gastroenterologist teaching fellows in various branches of the military to become a Gastroenterologist.

The work was rewarding & humbling. I did more learning than I did teaching. 😅

But like many clinicians, the rigorous demands of healthcare and lack of autonomy can be a burden that weighs on someone’s spirit.

🐀I found myself in the rat race of not being able to practice medicine on my own terms and not able to offer all of what I know to my patients.

❌That’s why I ended up quitting my job and started working in locums as a traveling physician helping short staffed gastroenterology practices.

This afforded me the time and space to work when I wanted, gain control of my schedule so that I could be more present as a mom and wife.

With that extra time I ended up starting a business, @unlockinggi and work with my husband on our company @gamebeyondthegame

We have also been able to travel the world and take months off at a time when I want.

And I finally received my first public review. 🤯Working at the Navy all of our patient reviews were internal. I am So excited for my first hospital review - crazy even tho I’ve been practicing medicine for 14 years! 😅

Also excited to be recognized by @amergastroassn Latinos in Gastroenterology and Hepatology (La LiGaH) as an official AGA member network.

This sort of stuff didn’t just happen overnight, but I took baby steps, many mis steps, & some crying ….all over many years in the making.

I’m sharing this to inspire anyone that feels stuck, lost or just no longer has the fire within them. Keep going. You got this.

the possibilities are endless. by @leybelismd

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a year ago

I had one of those cases recently that really stuck with me.

I was taking care of a patient with a huge stomach ulcer — like a crater — that had already bled once. His blood count was 4.8 (which is really low), and he was refusing a blood transfusion and another procedure that he actually needed to stop the bleeding.

When I walked into the room, I could feel the tension. There were nurses, the hospitalist, anesthesia — everyone trying to convince him what to do.

But it just didn’t feel right. So I asked everyone to step out. I wanted to talk to him one-on-one.

We talked for a while. I explained what was going on, what I was worried about, and why this next step mattered. He told me he felt pressured, like no one was really listening.

This was in a predominantly white hospital, and he was likely one of only a handful of Black patients in the entire place. I could feel his guard up — and I understood why.

Then he asked me, “How many Black patients have you treated?”

I smiled and said, “I trained at Howard.”

I had never been asked that question before.

He looked at me for a second and said, “Okay. I trust you. Let’s do it.”

My time at Howard University College of Medicine @howard1867 taught me more than just medicine. It taught me how to see people.

That moment reminded me how powerful our stories are.

We never know when a piece of who we are — our background, our experiences — might be exactly what someone needs to hear to feel safe.

So yeah, I’m forever grateful for my time at Howard.

And for every patient who reminds me that this job is about so much more than procedures and lab results — it’s about connection.

I share these moments because care isn’t one-size-fits-all — it’s deeply human.

My grandmother taught me that when you care for someone, you do it with your whole heart — 1,000%. That’s what I bring into every patient relationship.

Especially for those struggling with digestive issues, feeling dismissed or unseen can make everything harder.

If you’re tired of feeling unheard or just want real answers, take my free Gut Health Quiz — link in bio.

@unlockinggi your story matters, and care feels human again. by @leybelismd

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a year ago

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4 hours ago

* Fewer young people are drinking overall than 20 years ago.
* BUT…….those who do drink are drinking harder. Overall use is down, but the heaviest drinkers aren’t cutting back.
* Nearly 1 in 4 adults ages 18–29 report signs of an alcohol use disorder in the past year.
* Cirrhosis is rising in young adults, with hospitalizations for alcohol-related liver disease climbing fastest in people under 50
* Alcohol is now the #1 reason for liver transplants in the US and Europe, and is behind about half of cirrhosis hospitalizations
* Young women are hit hardest, with liver transplant rates rising nearly 20% per year and hospitalizations about 9% per year.
* Deaths from alcohol-related liver disease could double by 2040 if nothing changes.

Share this with someone you care about & maybe consider turning that next happy hour invitation into an after work hike 🫶

References:
Ryan SA, et al. Alcohol Use by Youth. Pediatrics, 2019.

Harris NA, Weitzman ER. Intensifying Substance Use Trends Among Youth. Current Psychiatry Reports, 2024.

Pinquart M. Change in Alcohol Consumption in Adolescence and Emerging Adulthood. J Stud Alcohol Drugs, 2024.

Jophlin LL, et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol, 2024.

Pan CW, et al. Alarming Rise in Alcohol-Associated Liver Disease Hospitalization in Young Adults. Alcohol Clin Exp Res, 2025.

Danpanichkul P, et al. Global Epidemiology of Alcohol-Associated Liver Disease in Adolescents and Young Adults. Aliment Pharmacol Ther, 2024.

Sethi V, et al. Trends in Hospitalizations and Liver Transplants Associated With Alcohol-Induced Liver Disease. JAMA, 2025. by @leybelismd

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5 days ago

The simplest bloating fix isn’t a supplement.

It’s your sneakers. 👟

A 10–15 minute walk after meals helps your gut move food along, eases gas and pressure, and steadies your blood sugar. No equipment, no cost, just movement.

📲 Send this to the person you’d love to take an after-dinner walk with. Bc Better digestion *and* better conversation? That’s a win-win. 💛

#FoodAsMedicine #GutHealth #Bloating #Movement #UnlockingGI by @leybelismd

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10 days ago

Saw someone with long-standing iron deficiency that was never explored but she thought it was due to her periods or so that’s what she was told.

But what I want you to know is that part of the evaluation of iron deficiency anemia to make sure you don’t have a bacterial infection of the stomach called h pylori or helicobacter pylori.

And this can be tested with a blood test, breath test, stool test, or EGD/upper endoscopy with biopsies of the stomach.

Knowing if you have this bacterial infection is important because it is a carcinogen & can increase your risk of stomach cancer.

So get checked!

#guthealth #gastroenterologist #unlockinggi #irondeficiency #anemia by @leybelismd

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13 days ago

Hispanic heritage month is personal. 🇵🇷

Born in Puerto Rico, raised around the world, and for years insecure about my Spanish.

Earlier this year @danielaganoza with @codigovitalpodcast asked me to speak about gut health en español. 😳 for me, it was a BIG deal.

I did it & I’m so damn proud. This episode aired & you can watch on YouTube which I will like in bio. 🫶

Send this to your Latino friends to get screened & checked out so we can be on top of our health!

References
1. Cancer Statistics for the US Hispanic/Latino Population, 2021. Miller KD, Ortiz AP, Pinheiro PS, et al. CA: A Cancer Journal for Clinicians. 2021;71(6):466-487.

2. Prevalence of Colorectal Cancer Screening Among Latino Adults Following the Medicaid Eligibility Amendment Expansion. Huguet N, Kaufmann J, Holderness H, et al. JAMA Network Open. 2026

3. Incidence, Prevalence, and Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States. Lewis JD, Parlett LE, Jonsson Funk ML, et al. Gastroenterology. 2023;165(5):1197-1205.

4. Seroprevalence of Helicobacter Pylori Infection Among Asymptomatic Patients Served by a Safety-Net Healthcare System. Thrift AP, Dinarvand P, Juarez L, et al. Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association. 2026;24(5):1289-1297. by @leybelismd

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15 days ago

While everyone is trying to over complicate their lives with more wellness trends & supplements, these 5 habits are the foundation to my health.

1. Chewing your food. Digestion starts in the mouth. Chew thoroughly per bite and your gut does less of the heavy lifting.

2. A 10-minute walk after meals. It supports motility and blunts blood sugar spikes. It’s one of the easiest “prescriptions” I give.

3. Plant diversity over “perfect” eating. Variety feeds a more diverse microbiome. Aiming for ~30 different plants a week (herbs, spices, nuts and seeds count).

4. Eating calmly. Your gut digests best in “rest and digest” mode. Eating while stressed, scrolling or rushing works against you. Try three slow breaths before your first bite.

5. Sleep. Your gut runs on a circadian rhythm. Poor sleep and late-night eating show up as bloating, reflux and cravings.

So which is your fav or which one are you starting this week?

Share this with someone who needs a little reminder that sticking with the basics is a good bet for their health. by @leybelismd

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19 days ago

Let’s talk about iron, because most of you are taking it in a way that’s making you miserable. 🩸

Every other day. One dose.

But the part I really need you to hear: iron will turn your stool dark. That’s expected.

What is NOT expected is stool that’s black, sticky, tarry, and smells different than usual. Don’t assume it’s the supplement. Get seen bc that could be the reason why you need iron in the first place.

And always remember figuring out the WHY is the most important thjng. You don’t want to find yourself blindly taking iron supplement for an anemia or even low iron levels without anemia without a clear why or at least an attempt to a basic work up.

Start with your PCP ➡️ Gastroenterology ➡️ Hematology.

Although sometimes you get sent directly to hematology first from your PCP and that’s OK too; the point is the process of looking for the why has begun.

From the gastroenterology standpoint that includes checking for H. pylori infection as well as celiac disease at a MINIMUM.

DeLoughery T, Jackson C, Ko C ... AGA Clinical Practice Update on Management of Iron Deficiency Anemia: Expert Review Clinical Gastroenterology and Hepatology, 2024; 22, 1575-1583

Of course recent guidelines updates:
Powers J, Lim M, Achebe M ...American Society of Hematology 2026 Guidelines for Diagnosis of Iron Deficiency by @leybelismd

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20 days ago

Iron pills aren’t the finish line. They’re a clue. 🔎

The biggest mistake I see? Taking iron without asking WHY you’re low in the first place.

And when you DO supplement here are a few tips:

📅 Once a day at most. Every other day can sometimes work even better. Each dose raises hepcidin, a hormone that blocks iron absorption for about 24 hours, so giving it a day to reset helps more of the next dose get in.

🍊 Pair it with vitamin C to boost absorption.

💉 IV iron is an option if you can’t tolerate pills, your ferritin isn’t rising, or your gut can’t absorb iron well (for example, after bariatric surgery).

DeLoughery T, Jackson C, Ko C ... AGA Clinical Practice Update on Management of Iron Deficiency Anemia: Expert Review Clinical Gastroenterology and Hepatology, 2024; 22, 1575-1583

And more recent guidelines updates:
Powers J, Lim M, Achebe M ...American Society of Hematology 2026 Guidelines for Diagnosis of Iron Deficiency

#guthealth #gastroenterologist #unlockinggi #digestivehealth by @leybelismd

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23 days ago

As a gastroenterologist, I’ve spent years recommending these same tools to my patients — meditation, journaling, a daily gratitude practice, yoga — because what happens in your nervous system doesn’t stay in your nervous system. Your gut is listening.

So tell me: what do you reach for in moments of anxiety or high stress? 👇

And send this to someone who needs the reminder — before reaching for the next supplement, consider that the most powerful tool you have is already inside you.

#guthealth #gastroenterologist #unlockinggi #digestivehealth #unlockinggi by @leybelismd

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24 days ago