Pezim Clinic services

GI Diagnostic Centre

The Pezim Clinic is the first free-standing gastrointestinal diagnostic and treatment centre in British Columbia. It has been designed exclusively to meet the needs of patients with disorders of the gastrointestinal tract and those that wish to prevent gastrointestinal disease.

Rapid access

Intestinal disorders cause significant worry and diminished quality of life for those affected. However, since they are rarely immediately life-threatening, patients often experience substantial waits for consultation, diagnosis and treatment in British Columbia. Pezim Clinic staff understand the needs of patients with intestinal disorders. As a free-standing centre with its own diagnostic and treatment facilities, the Pezim Clinic can provide most consultations, investigations and treatments within two weeks of a request.

Rapid diagnosis and treatment of anorectal conditions

Rectal bleeding is most often benign. However, it can be a serious sign of trouble in some cases. Rapid diagnosis is needed to rule out the serious causes. The specialist may recommend examination of the colon by flexible sigmoidoscopy or colonoscopy or immediate treatment if the problem seems to be simply bleeding hemorrhoids.

Anal pain is most often benign. Common causes include fissure-in-ano, severe anal dermatitis, certain types of hemorrhoid problems, and infections (abscesses). The diagnosis can usually be determined immediately. Higher colon examinations are usually not necessary.

Hemorrhoids may cause bleeding, protrusions or pain. For bleeding and protruding hemorrhoids, the Pezim Clinic offers infrared photocoagulation treatment. For painful or very large hemorrhoids, excision of the hemorrhoid ("hemorrhoidectomy") may be the best option. The Pezim Clinic can provide rapid hemorrhoidectomy in certain cases.

A fissure-in-ano is a painful tear in the lining of the anal canal. In most cases, dietary recommendations can lead to improvement and healing. For those that experience severe, disabling pain, additional management is required. Special ointment, a sphincterotomy (a small operation performed under local anaesthetic), or Botox™ injections into the anal area may be recommended to eliminate the problem.

Abscesses in the anal area can present with severe pain, local redness and swelling, and drainage. Initial treatment involves drainage and sometimes the addition of antibiotics. In most cases, this can be done immediately at the Pezim Clinic.

A fistula is a tunnel or tract that leads from the inside of the anus out to the skin. The external opening of the tract drains fluid. Fistulas are most often the result of a previous abscess. They will occasionally resolve with long-term antibiotics but will often require surgical treatment. In many cases, this can be done under local anaesthetic at the Pezim Clinic.

Colonoscopy and biopsy/polypectomy

Colonoscopy is the most accurate way of assessing the colon and rectum for polyps and other abnormalities. A colonoscope is a 160 cm long flexible instrument that can be steered by the operator through the entire colon. The colonoscope has either a fibre optic or digital viewing capability that provides the operator with an excellent view of the lining of the colon. Polyps, the precursors of colon cancer, can usually be removed by means of the colonoscope, eliminating the need for more invasive traditional surgery. Complete cleansing of the colon is required prior to colonoscopy and intravenous conscious sedation is used to make the procedure more comfortable. Pezim Clinic staff has performed over 3,000 colonoscopies with no significant complications.

Colorectal cancer screening programs

Colorectal cancer is the second leading cause of cancer-related deaths in Canada and the United States. There is a 1 in 16 lifetime chance of developing colorectal cancer. The disease strikes men and women in equal proportions. For those with a family history of colorectal cancer, the risk may in crease significantly. Colorectal cancer has a high survival rate if detected early.

By the time symptoms appear, cancer can be well established and, in many cases, already spread to other parts of the body. In order to maximize the chances of a cure, colon and rectal cancer must be identified in its earliest phases, before symptoms occur. Screening is the process of looking for cancer or the precursors of cancer in individuals who have no symptoms. Screening for colon and rectal cancer is particularly sensible since the precursors of this disease (polyps) usually exists in a long, symptom-free phase during which they can be easily detected and eliminated. Colorectal cancer screening is a nuisance, but it could provide you with decades of additional life. It is an important thing for you to do, both for yourself and for your family.

The Pezim Clinic offers colorectal cancer screening programs for patients with a normal risk of colorectal cancer, and programs for those with increased risk. In either program, screened patients are entered into the online Pezim Clinic Colonoscopy Registry that provides password-protected online access to the colonoscopy results to give you the most accurate and timely means by which you and your medical providers can keep track of your colon health.

Pezim Clinic Colonoscopy Registry

The Pezim Clinic Colonoscopy Registry is an online record of your colonoscopy procedure, permitting password-protected access for you or your physician. The registry provides a record of the date of the procedure, technical details, procedural findings including description of the bowel and polyps, recommendations, and pathology results if applicable. This is a unique registry that permits you and your physician to have accurate access to your colonoscopy record at any time. Pezim Clinic registrants are provided a password and receive email notification of future colonoscopy requirements and other pertinent information.

Second Opinion Program

Questions and concerns about whether you are making the right treatment choice can leave you and your family with a feeling of loss of control and anxiety that can interfere with your progress though your treatment stages.

Do I really need surgery?
Are there rational alternatives to surgery? If so, what are they?
What is the risk of delay?
Is the operation that has been proposed the right one?
Is there a more conservative surgical option?
Why have I been told I might need a colostomy? Can't that be prevented?
Are we certain that this will cure my situation?
Shouldn't I have been better by now?

The Pezim Clinic offers prompt, confidential opinions on your current management from a surgeon with international training and a wealth of operative experience. We specialize in all aspects of intestinal surgery care such as colorectal cancer surgery, inflammatory bowel disease surgery including complex Crohn's disease, ulcerative colitis and the pelvic pouch operation, diverticulitis, rectal prolapse and difficult anorectal problems.

The aim of the Second Opinion Program at the Pezim Clinic is provide you with the information you need to take an active part in your treatment. You will be equipped to move ahead with the confidence that you more fully understand the nature of your condition and the management options and will be better able to move through the stages of treatment.