Doctors' Program

Naoki Chiba MD, MSc, FRCP(C), AGAF, CAGF

 

Dr. Chiba is a Guelph based community gastroenterologist with interest in ERCP and office endoscopy. He also has an academic appointment as Clinical Professor at McMaster. He received his MD (Cum Laude) in1986 from UWO. He completed gastroenterology and research training fellowships at McMaster University in 1992 and in 2004, he completed his Masters in Health Research Methodology at McMaster. Primary research interests focus on acid related disorders including GERD, ulcer disease, Helicobacter pylori and dyspepsia. When not working, Dr. Chiba sings with the Guelph Chamber Choir, enjoys golf and has two best buddies Murphy and Molly, his beloved bearded collies.

Presentation Overview
Triple therapy efficacy – especially for 7 days has now declined sufficiently that it cannot be recommended any longer as first line therapy. First line therapy should now probably be given for 14 days – recommend quadruple therapy with PPI-bismuth-metronidazole and tetracycline or a regimen of PPI-clarithromycin-amoxicillin-metronidazole. Treatment failures should likely be given PPI-BMT or PPI-Levofloxacin-amoxicillin for 14 days. Intestinal metaplasia (IM) and gastric atrophy (GA) are precancerous lesions. H. pylori eradication does not reliably improve IM and GA – it may be too late by then. However, H. pylori eradication may reduce risk of gastric cancer. Current recommendations suggest that H. pylori should be treated at an early age prior to the development of IM and GA to prevent gastric cancer, screen and treat as opposed to test & treat – need to consider both.

Christopher Teshima, MD, MSc (Clin Epi), PhD

 

Christopher Teshima attended medical school at the University of Toronto, completed residency training in Internal Medicine at U of T, and then trained in Gastroenterology at the University of Alberta, where he also did a research fellowship leading to a Masters degree in Clinical Epidemiology. He then pursued an Advanced Endoscopy Fellowship at Erasmus MC University Medical Centre in The Netherlands in 2009 and 2010, where he continued research resulting in a PhD.

He then joined the Division of Gastroenterology as an Assistant Professor at the University of Alberta in 2010, where he became director of the Therapeutic Endoscopy Training Program in 2013. Earlier this year he moved to Toronto to join the Therapeutic Endoscopy group at St Michael's Hospital. His clinical interests focus on upper GI neoplasia, endoscopic mucosal resection, endoscopic therapy for pancreatic pseudocysts and walled-off necrosis, Zenkers diverticulum, small bowel endoscopy for obscure GI bleeding, and endoscopic ultrasound.

Presentation Overview
Objectives:

1. To review current strategies for managing Barrett’s esophagus.
2. To outline an approach to gastric polyps.
3. To discuss a strategy for subepithelial lesions encountered on upper endoscopy.
4. To contemplate what you should resect, what you should refer, what you can ignore?

Alan Barkun, MD,CM, FRCP(C), FACP, FACG, AGAF, MSc (Clinical Epidemiology)
Chairholder, Douglas G. Kinnear Chair in Gastroenterology and Professor of Medicine,
Chief Quality Officer, Division of Gastroenterology,
McGill University and the McGill University Health Centre.

 

Alan Barkun is Director of Digestive Endoscopy, and Chief Quality Officer of the Division of Gastroenterology at McGill University and McGill University Health Centre, Montréal, Canada. He is the first and current recipient of the DG Kinnear Chair in Gastroenterology at McGill University, holding a medical degree and an MSc in epidemiology and biostatistics from McGill University. Recipient of many national and international awards, Dr. Barkun has published over 400 peer-reviewed articles and abstracts, and has given over 400 international presentations on emerging digestive endoscopic technologies, with an emphasis on methodological, clinical and cost-effectiveness trials of treatments for upper gastrointestinal bleeding (UGIB), bilio-pancreatic diseases and colorectal cancer screening.

Presentation Overview
The management of patients with non variceal upper gastrointestinal bleeding has evolved significantly over the past decade, as has the profile of affected patients. These exhibit more serious co-morbidities, including malignancies and chronic kidney disease, resulting in worse outcomes. There have been modifications in traditional pre-, and post-procedural management strategies of patients at risk of negative outcomes, including a revision of transfusional strategies, a reassessment of optimal approaches in the era of novel oral anticoagulants, and the selected use of prokinetic agents. There has arisen controversy as to optimal pharmacological therapies dosing schemes. Additionally, potentially disruptive therapeutic technologies have also emerged in the past 3-4 years, including hemostatic powders. Their optimal role remains uncertain, yet observational data suggest caution when adopting these as indiscriminate sole hemostatic modality in all patients with actively bleeding lesions. A review of emerging evidence and existing consensus recommendations will provide the focus for this presentation.

Gary R. May MD, FRCPC, FASGE
Head, Division of Gastroenterolgy
St. Michael's Hospital
Associate Professor of Medicine
Division of Gastroenterology, University of Toronto

 

Dr. Gary May received his MD from the University of Alberta in Edmonton, Alberta (1985), completed his internship and internal medicine training at the University of British Columbia, and his Gastroenterology training at the University of Calgary (1991). Dr. May completed his fellowship training in biliary and advanced therapeutic endoscopy at Duke University Medical Centre, Durham, North Carolina (1993). From 1993 to 2004, Dr. May was on the faculty at the University of Calgary where he practiced at the Foothills Hospital. In 2004, Dr. May was recruited to St. Michael's Hospital where his interests as a clinician teacher are in advanced therapeutic endoscopy including ERCP, endoscopic ultrasound and endoscopic oncology. He is currently the head of the Division of Gastroenterology at St. Michael's Hospital.

Presentation Overview
Pancreatic cysts are frequently being found as incidental findings in patients undergoing imaging for other indications.  The vast majority of these cysts will not ever be clinically significant however a small proportion will be at higher risk for malignant transformation and require intervention.  I will present an overview for the evaluation and management of patients with  incidental pancreatic cysts. 

Lawrence Hookey, MD, FRCP(C)
Associate Professor, Gastroenterology, Queen's University
VP Clinical Affairs, Canadian Association of Gastroenterology
Quality Lead for Endoscopy in Southeastern Ontario
Medical Director for Endoscopy, Hotel Dieu and Kingston General Hospitals

 

Dr. Lawrence Hookey completed his medical school training at Memorial University, and then he did his Internal Medicine and Gastroenterology training at Queen's. From there he went to Belgium and France for a two-year clinical research fellowship in advanced therapeutic endoscopy. He returned to Queen's in 2005. He has interests in clinical research in preparation for colonoscopy, medical education (specifically endoscopy training), and quality in endoscopy. His clinical practice continues to be a general GI practice with a focus on pancreatitis and therapeutic endoscopy.

Sean P. Cleary BScH, MD, MSc,MPH, FRCSC
Associate Professor, University of Toronto
General Surgery, Pancreatic and Hepatobiliary Surgery
Research Associate, Samuel Lunenfeld Research Institute

 

Sean Cleary is Hepatobiliary and Pancretic Surgical Oncologist and an Associate professor in the Department of Surgery at the University of Toronto. He received a BScH from Queen's University and his MD from the University of Western Ontario. He completed a General Surgery residency and fellowship training in Hepatobiliary and Pancreatic Transplantation and Surgical Oncology at the University of Toronto. In addition he obtained a Masters of Science in Cancer Genetics followed by a MPH in Public Health and Epidemiology in the Dala Lana School of Public Health at the University of Toronto. Sean is a staff surgeon in the Divisions of General Surgery and Surgical Oncology at the Toronto General Hospital and a Research Associate in the Prosserman Centre for Health Research at the Lunenfeld-Tanenbaum Research Institute. His clinical interests include the surgical treatment of pancreatic, hepatic and biliary malignancies with a specific focus on minimally invasive approaches to these cancers. His research interests include the genetic epidemiology of pancreatic and hepatocellular cancers.

Presentation Overview
The effective management of hepatocellular carcinoma (HCC) depends on early and accurate diagnosis as well as the selection of optimal therapy based on tumour and patient characteristics. Screening of at-risk populations offers the best opportunity for early diagnosis of HCC and improved outcomes. Current guidelines stress the use of multi-modality contrast-enhanced imaging for the non-invasive diagnosis of HCC with biopsy reserved for atypical or indeterminate lesions. The treatment of HCC requires the simultaneous assessment and management of both the malignancy and underlying liver disease. Curative treatment options for early HCC include ablation, surgical resection and liver transplantation. Trans-arterial chemoembolization and systemic therapy may be considered in patients with advanced HCC with well preserved liver function. Radiation therapy is emerging as a treatment for palliative, and potentially curative treatment of HCC. The evidence and considerations around treatment strategies will be reviewed.

Christopher Graham, MD, FRCP(C)
Medical Director Trillium Health Partners
Antimicrobial Stewardship Program
Division of Infectious Diseases
Trillium Health Partners

 

Dr. Chris Graham is a community based Infectious Diseases physician at Trillium Health Partners (THP). He is Medical Director of the Antimicrobial Stewardship Program at THP, and is initiating a Fecal Microbiota Therapy program. He has an interest in HIV, mycobacterial infections and the human microbiome. His MD, General Internal Medicine training and Fellowship in Infectious Diseases were all completed at the University of Toronto. In addition to working at THP, he has worked overseas in Zimbabwe and Malawi.

Presentation Overview
Treatment of severe and recurrent C. difficile infections remains frustrating due to a lack of effective and evidence based therapies, although the evidence base is beginning to evolve. Bacteriotherapy is a promising treatment option for recurrent disease but many questions remain. New changes to the regulatory status of fecal bacteriotherapy in Canada now allows for more widespread adoption of this procedure. However, advancements in our understanding of the human microbiome raises concern for long term complications of fecal bacteriotherapy and the need for rigorous screening of donors and the monitoring of long term outcomes. These same advancements in understanding of the human microbiome are also leading to targeted bacteriotherapy and novel antimicrobials. This presentation will review emerging evidence and provide an understanding for the future direction of C. difficile therapeutics and prevention.

BRIAN G. FEAGAN, M.D., FRCPC
Professor of Medicine
Division of Gastroenterology
Departments of Medicine, Epidemiology and Biostatistics
CEO & Senior Scientific Director, Robarts Clinical Trials Inc
Robarts Research Institute
London Health Sciences Centre
University of Western Ontario
London, Ontario, Canada

 

Brian G. Feagan completed a medical degree at the University of Western Ontario in London, Ontario, Canada.  His postdoctoral training included residency in the Department of Medicine and a fellowship in Gastroenterology at the University of Western Ontario.

A Fellow of the Royal College of Physicians and Surgeons of Canada, Dr. Feagan holds membership in the Canadian and American Association of Gastroenterology, the American College of Gastroenterology, the College of Physicians and Surgeons of Ontario, Crohn’s and Colitis Canada (CCC) and the European Crohn’s & Colitis Organization (ECCO).  He is the recipient of the 2013 Senior Achievement Award from the Crohn’s & Colitis Foundation of America (CCFA) and Dean’s Award of Excellence in 2013 from the University of Western Ontario. He has authored over 200 articles, book chapters and has also given over 900 invited presentations, and national and international scientific meetings. 

In 1997, Dr. Feagan became Director of Robarts Clinical Trials at the Robarts Research Institute, University of Western Ontario.  His research efforts focus on the design and implementation of randomized controlled trials of therapy for inflammatory bowel disease.  He has been the principal investigator on numerous large-scale randomized clinical trials.

Daniel Green MD, FRCPC
Active Staff Gastroenterologist Lakeridge Health
Assistant Professor Department of Medicine Queen's University

 

Dr. Green completed his gastroenterolgy training at the University of Toronto and a fellowship in Advanced Therapeutic Endoscopy at St. Michael's Hospital.

He is a staff Gastroenterologist at Lakeridge Health and holds an academic appointment of Assistant Professor of Medicine at Queen's University.

In addition, he has an interest in clinical research and is the Principal Investigator for several Phase III studies in Inflammatory Bowel Disease and acts as the medical advisor to the Durham East chapter of the Crohn's and Colitis Foundation of Canada.

James C. Gregor, MD, FRCP(C)
Victoria Hospital Site Chief,
London Health Sciences Centre
Associate Chair, Western University
Professor of Medicine,
Department of Medicine
Past President,
Ontario Association of Gastroenterology

 

Dr. James C. Gregor is a Professor of Medicine in the Departments of Medicine in the Schulich School of Medicine and Dentistry at Western University.

Dr. Gregor graduated from the University of Western Ontario in 1988, and specialized in Internal Medicine and Gastroenterology. He did further training in Clinical Epidemiology and Health Economics at the University of Toronto.

Dr. Gregor joined the Medical Staff at The London Health Sciences Centre in 1995. He served as Program Director for the Division of Gastroenterology from 1998 to 2009. Currently he is the Site Chief for the Department of Medicine at the LHSCVictoria Hospital, Associate Chair of Medicine at Western University. Dr. Gregor is the immediate Past President of the Ontario Association of Gastroenterology and is Chair and organizer of the annual Scholars' Program for the Canadian Association of Gastroenterology. He is past Chair of the Specialty Committee in Gastroenterology for the Royal College of Physicians & Surgeons of Canada.

His research interests include therapeutic endoscopy, inflammatory bowel disease, celiac disease and economic analysis and quality of life assessments in Gastroenterology.

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Daniel Green MD, FRCPC
Active Staff Gastroenterologist Lakeridge Health
Assistant Professor Department of Medicine Queen's University

 

Dr. Green completed his gastroenterolgy training at the University of Toronto and a fellowship in Advanced Therapeutic Endoscopy at St. Michael's Hospital.

He is a staff Gastroenterologist at Lakeridge Health and holds an academic appointment of Assistant Professor of Medicine at Queen's University.

In addition, he has an interest in clinical research and is the Principal Investigator for several Phase III studies in Inflammatory Bowel Disease and acts as the medical advisor to the Durham East chapter of the Crohn's and Colitis Foundation of Canada.

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Sapna Makhija, MD, FRCP(C)
GI Health Centre (GIHC)

 

Dr. Sapna Makhija started her undergraduate education at the University of British Columbia, followed by a medical degree from the University of Saskatchewan.

During medical school Dr. Makhija exhibited leadership and academic excellence, including holding a position on the Student Medical Society, receiving a scholarship from the Leukemia Research Fund of Canada, and graduating with distinction in 2002.

Dr. Makhija's post-graduate education includes completing an Internal Medicine residency and further specialization in Gastroenterology at the University of Calgary. Her leadership and academic pursuits involved serving as chief resident, as well as partaking in a number of research projects. She has published journal articles in gastroenterology, and has written a textbook chapter. After residency, Dr. Makhija completed a fellowship in Clinical Nutrition and Obesity at the University of Toronto, and has published in the area of nutritional assessment.

Since completing her academic and clinical training, Dr. Makhija has worked throughout the Greater Toronto Area, as well as locum tenens in British Columbia and Ontario. She enjoys diverse patient populations as she speaks English as well as Hindi and Punjabi. She has chosen to make GI Health Centre her primary practice where she can combine her extensive gastroenterological knowledge with her nutrition background. Dr. Makhija prides herself in maintaining a well-balanced lifestyle of work and pleasure. She enjoys traveling, photography, cultural dancing, and organizing fundraising events.

Gary R. May MD, FRCPC, FASGE
Head, Division of Gastroenterolgy
St. Michael's Hospital
Associate Professor of Medicine
Division of Gastroenterology, University of Toronto

 

Dr. Gary May received his MD from the University of Alberta in Edmonton, Alberta (1985), completed his internship and internal medicine training at the University of British Columbia, and his Gastroenterology training at the University of Calgary (1991). Dr. May completed his fellowship training in biliary and advanced therapeutic endoscopy at Duke University Medical Centre, Durham, North Carolina (1993). From 1993 to 2004, Dr. May was on the faculty at the University of Calgary where he practiced at the Foothills Hospital. In 2004, Dr. May was recruited to St. Michael's Hospital where his interests as a clinician teacher are in advanced therapeutic endoscopy including ERCP, endoscopic ultrasound and endoscopic oncology. He is currently the head of the Division of Gastroenterology at St. Michael's Hospital.

Presentation Overview
Video highlights of the recent 28th Annual Course in Therapeutic Endoscopy will be presented. This will include videos of POEMS, Colonic polypectomy, ESD, ERCP and EUS

Iain Murray, MD CM, FRCP(C)
President, Ontario Association of
Gastroenterology
Section Chair, OMA Section
of Gastroenterology

 

Dr. Iain Murray's family immigrated from far overseas in 1972. He attended school and CEGEP on the island of Montreal. His Bachelor of Science was obtained at the University of Toronto and Master's degree at the Anatomy Department of McGill University. He graduated from McGill Medical School in 1990. Dr. Murray did his post-graduate training in Internal Medicine and Gastroenterology at the University of Western Ontario. He first set up practice at Markham-Stouffville hospital in 1995. In 2003 he became co-found of the current Intestinal Health Institute where he continues his gastroenterology practice. Dr. Murray is the current President of the Ontario Association of Gastroenterology. He is also the Chair of the Section on Gastroenterology at the Ontario Medical Association. Dr. Murray is married with three children.

Nancy Baxter MD, PhD, FRCSC, FACRS
Department of Surgery
St. Michael's Hospital

 

Dr. Nancy Baxter obtained her MD from University of Toronto (UofT) followed by general surgery training and PhD in Clinical Epidemiology at UofT. She completed her fellowship at the Mayo Clinic and is board certified in colon and rectal surgery (2002) and a Fellow of the ASCRS. Currently, she is a practicing colorectal surgeon and the Chief, Division of General Surgery at St. Michael's Hospital. She holds a Scientist position with the Li Ka Shing Knowledge Institute. Dr. Baxter holds the position of Provincial GI Endoscopy Lead with Cancer Care Ontario.

Dr. Baxter is an Associate Professor in the Department of Surgery and Institute of Health Policy, Management and Evaluation at the UofT and a Senior Scientist in the Cancer Theme Group at the Institute for Clinical Evaluative Sciences (ICES). She is a health services researcher interested in the effectiveness of cancer screening, long-term survivorship of cancer survivors and quality of surgical care.

Her clinical interests include the care of rectal cancer patients, minimally invasive colon surgery as well as the surgical treatment of complex benign colorectal disorders including inflammatory bowel disease and rectal prolapse.

David Morgan, MD, MSc., FRCP(C)
Head, Service of Gastroenterology
St. Joseph's Healthcare, Hamilton
Associate Professor,
Division of Gastroenterology
McMaster University
Vice President, OAG

 

Dr. David Morgan completed his undergraduate training in Human Genetics at McGill University. He did graduate studies including a Masters in Population Genetics. His undergraduate medical studies were competed at McMaster University and Post Graduate studies including Internal Medicine and Gastroenterology, were also completed at McMaster. Dr. Morgan took an additional fellowship year with special attention paid to advanced endoscopic techniques including YAG laser.

Dr. Morgan has published on topics such as GI Bleeding, Quality of Life in Cancer Care, Use of Proton Pump Inhibitors and The Prevention of Bleeding from GI Vascular Lesions. Dr. Morgan has participate on several CAG Consensus Panels dealing with such topics as CRC Screening. Dr. Morgan is a member of several international societies, is a Past President of the Canadian Association of Gastroenterology and is the current Vice President of the Ontario Association of Gastroenterology. Dr. Morgan is an Associate Editor for the ACP Journal Club and Evidence Based Medicine and has acted as a reviewer for many journals.

Dr. Morgan is on the Faculty at McMaster University and is involved in teaching at the undergraduate and post-graduate levels. He serves on many university and hospital committees. Dr. Morgan is Head of the Service of Gastroenterology and Deputy Chief of Medicine at St. Joseph's Hospital, Hamilton.

Iain Murray, MD CM, FRCP(C)
President, Ontario Association of
Gastroenterology
Section Chair, OMA Section
of Gastroenterology

 

Dr. Iain Murray's family immigrated from far overseas in 1972. He attended school and CEGEP on the island of Montreal. His Bachelor of Science was obtained at the University of Toronto and Master's degree at the Anatomy Department of McGill University. He graduated from McGill Medical School in 1990. Dr. Murray did his post-graduate training in Internal Medicine and Gastroenterology at the University of Western Ontario. He first set up practice at Markham-Stouffville hospital in 1995. In 2003 he became co-found of the current Intestinal Health Institute where he continues his gastroenterology practice. Dr. Murray is the current President of the Ontario Association of Gastroenterology. He is also the Chair of the Section on Gastroenterology at the Ontario Medical Association. Dr. Murray is married with three children.

Alaa Rostom, MD, FRCP(C)
Chief of Gastroenterology,
The Ottawa Hospital

 

Dr. Alaa Rostom is the Chair of the Division of Gastroenterology, at the Ottawa Hospital and University of Ottawa. He is also the Champlain region's endoscopy and quality lead and Cancer Care Ontario's Champlain regional Screening / Endoscopy Lead.

Dr. Rostom returns to Ottawa from the University of Calgary where he spent the last 7 years in the planning and implementation of the Calgary zone colorectal cancer screening program. He held several positions in Calgary including deputy chief division of gastroenterology, zone medical director of the Alberta colorectal screening program and medical director of the Colon Cancer Screening Centre. Dr Rostom was also the chair of the RCPSC Exam board for Gastroenterology and the Chair of Education for the Canadian Association of Gastroenterology (CAG). Dr. Rostom is actively involved in measuring and evaluating endoscopy quality and technology that assists in tracking endoscopy outcomes including quality in real time. He developed the first validated clinical instrument for the evaluation of comfort/safety during colonoscopy. He helped initiate the CAG's endoscopy Train the Trainers program as well as the endoscopy master's program during his tenure as Education Chair, and he currently co-chairs the CAG's Skills Enhancement in Endoscopy (SEE) program.

Dr. Rostom's research interests include endoscopy outcomes and quality, endoscopy clinical trials, Celiac Disease, and NSAID toxicity of the GI tract.