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H. pylori

What is it?

Helicobacter pylori (H. pylori) is a helical shaped Gram-negative bacterium that infects various areas of the stomach and duodenum. Many cases of peptic ulcers, gastritis, duodenitis, and perhaps some cancers are caused by the H. pylori infection. However, many who are infected do not show any symptoms of the disease.

What are the Symptoms?

  • Stomach pain
  • Nausea or vomiting
  • Heartburn
  • Diarrhea

Symptoms may be worse before or after meals. One third of the people who are infected never have any symptoms. By middle age, 50% of adults have been infected with H. pylori bacteria.

Diagnosis of Infection

Diagnosis of infection is usually made by checking for dyspeptic symptoms and then doing one of the following tests which can suggest H. pylori infection:

  • A non-invasive blood antibody test
  • A stool antigen test
  • A carbon Urea Breath Test (in which the patient drinks 14C or 13C– labeled urea, which the bacterium metabolizes producing labeled carbon dioxide that can be detected in the breath).
  • However, the most reliable method for detecting H. pylori infection is a biopsy check during endoscopy with a rapid urease test, histological examination, and microbial culture.

Treatment of Infection

In peptic ulcer patients where infection is detected, the normal procedure is the eradication of H. pylori to allow the ulcer to heal. The standard first-line therapy is a one-week triple therapy. Today, the standard triple therapy is amoxicillin, clarithromycin and a proton pump inhibitor such as omeprazole.

A meta-analysis of randomized controlled trials suggests that supplementation with probiotics can improve eradication rates and reduce adverse events.

Unfortunately, an increasing number of infected individuals are found to harbor antibiotic-resistant bacteria. This results in initial treatment failure and requires additional rounds of antibiotic therapy or alternative strategies such as a quadruple therapy. Bismuth compounds are also effective in combination with the above-mentioned drugs. For the treatment of clarithromycin-resistant strains of H. pylori the use of levofloxacin as part of the therapy has be suggested.

Helicobacter and cancer

While the incidence of H. pylori infection in humans is decreasing in developing countries, presumably because of improving sanitation and increasing use of antibiotics, in the United States the incidence of gastric cancer has decreased by 80% from 1900 to 2000. This apparent correlation is consistent with an epidemiological link between H. pylori and cancer. Specifically, both gastric cancer and gastric MALT lymphoma (lymphoma of the mucosa-associated lymphoid tissue) have been associated with H. pylori. Nonetheless, among bacteria suspected to cause cancer, H. pylori is the leading contender.

Dr. Ashwin Maharaj obtained his undergraduate degree in Biology/Physiology from the University of Western Ontario (BSc). e became certified through is a Diplomate of the American Board of Surgery and was certified as fellow of the American College of Surgeons (FACS) and recently recertified. He is a member of the Canadian Association of General Surgeons. His current clinical interests are devoted to outpatient acute and chronic gastrointestinal medicine/surgery as well as abdominal wall hernia surgery and practices in certified facilities in Toronto. He has research experience in gastrointestinal disease as well as surgical education teaching resident surgeons and medical students.

Dr. Diana Magee completed her undergraduate education at Cornell University followed by a Master of Public Health degree at Boston University. She received her medical degree from Queen’s University and completed her urology residency at the University of Toronto. While in residency she enrolled in the Surgeon Scientist program and completed her Master of Science in Health Services Research. She completed her fellowship in urologic oncology at Fox Chase Cancer Center in Philadelphia. Dr. Magee’s area of expertise is in the management of urologic cancers as well as performing minimally invasive surgery.

Dr. Pianezza completed his medical degree (MD) at the University of Ottawa in 2002. He became a member of the Royal College of Physicians of Canada (FRCSC). He then completed a one-year fellowship in minimally invasive surgery and endourology at the University of Alberta in Edmonton in 2008.

Dr. M. Pianezza has been a staff urologist in Sudbury at the Health Sciences North since January 2010. He was Head of Urology from February 2013 to September 2016. He is an Assistant Professor of Surgery at the Northern Ontario School of Medicine.

Dr. Heimrath completed his medical school at the University of Ottawa, his surgical residency at McGill University, and his Endourology, Minimally Invasive, and Robotics Fellowship at the University of Toronto. Dr. Heimrath’s areas of expertise include the management of complex kidney stones and urologic cancers as well as performing minimally invasive surgery. Since 2016, Dr. Heimrath has worked overseas in Malawi and Rwanda to explore opportunities to build urologic and surgical capacity in the developing world. He is a partner in the Urology Global Surgery initiative at the University of Toronto and holds a lecturer appointment with the University of Toronto.

Endoscopy

Procedures & Conditions Treated

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SIBO for IBS

Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine.

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Gastric ballon

The Clinic at Beverly Hills offers patients the option between two industry leading gastric balloon procedures. The traditional endoscopy guided Orbera Gastric Balloon and the revolutionary swallowable Allurion Gastric Balloon.

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Laser Hemorrhoid Treatment

Hemorrhoids are a natural part of the human body and, when healthy, assist with the closure of the anus.

Hemorrhoids are vascular cushions that move blood to and from the anus and help support the function of the sphincter. Most people think of hemorrhoids as the disorder known as hemorrhoids or piles.

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Stress Urinary Incontinence

Stress Urinary incontinence (SUI) means the uncontrollable loss of urine – an involuntary loss or leakage of urine during precipitating activities like coughing, laughing, sneezing, straining, exercising etc. Early signs of SUI are complaints relating to dysuria, frequency, and urgency. At TCBH Surgical Centre, we offer two treatment options for Stress Urinary Incontinence.

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iTind

Benign prostatic hyperplasia (BPH) is a condition in which your prostate grows in size. Your prostate is a gland that rests below your bladder and in front of your rectum. It’s about the size of a walnut, and it surrounds part of your urethra. Your urethra is a tube that carries urine and sperm (ejaculate) out of your body. If your prostate grows in size, it can prevent urine and ejaculation from passing through your urethra. BPH is not cancerous. However, symptoms of BPH may indicate more serious conditions, including prostate cancer. TCBH Surgical Centre provides two treatment options.

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Rezum Water Therapy

How The Rezum™ Water Vapor Therapy Works

  • RezumTM Water Vapor Therapy is a novel technology that helps people who are suffering from BPH symptoms.
  • In each application, sterile water vapor is released to the targeted prostate tissue. When the steam turns back into the water, all the stored energy is released, causing the cells to die.
  • Over time, your body’s natural healing response removes the dead cells, shrinking the prostate. With the extra tissue removed, the urethra opens, reducing BPH symptoms.
  • The maximum benefit may occur within three months.
    Patients’ responses to treatment can and do vary.
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Nanoknife for Prostate Cancer

NanoKnife or Irreversible Electroporation (IRE) consists of placing a number of electrodes into the prostate to surround the area of significant cancer.

Short pulses of electricity using very high voltage are passed between the electrodes. This causes micropores to occur in all cells, including the cancer cells, which lead to their death.

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Dr. Luke Fazio is the current Chief of Urology at Humber River Hospital. Dr. Fazio received his medical degree from McGill University in 1999. Following this, he finished his Endourology and Minimally Invasive fellowship at the University of Toronto. As the Urology Medical Director, he has brought many minimally invasive programs to TCBH and is working on future projects. He currently sits on numerous committees and is an advocate for innovation in healthcare. He is the physician lead for the Da Vinci Robotic Surgery Program. He also is the Chair of the Innovation Committee.

Dr. Bhargava has a primary focus of providing care for her patients in the form of minimally invasive procedures and cutting edge technology. She is the Medical Director of TCBH Surgical Centre (The Clinic at Beverly Hills Healthcare) and has been instrumental in bringing Laser Hemorrhoid Treatment to her Centre.

Achievements:
Dr. Bhargava completed both her medical school and surgical residency at the University of Western Ontario. In addition to her Bariatric fellowship, she has also completed Minimally Invasive fellowship at the University of Cincinnati in Ohio.
Dr. Bhargava has published multiple research papers and lead articles.

Memberships:
Canadian Medical Association, Canadian Association of General Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Royal College of Physicians and Surgeons of Canada, College of Physicians and Surgeons of Ontario, and American Society of Bariatric Surgery