The Clinic at Beverly Hills

Call: (647) 352–3233 | Fax: (416) 630–6415




Irritable bowel syndrome (IBS) is a gastrointestinal (GI) disorder characterized by altered bowel habits in association with abdominal discomfort or pain in the absence of detectable structural and biochemical abnormalities. It is a disorder that affects your lower GI (gastrointestinal) tract, this includes the small intestine and large intestine (colon). It is diagnosed when a person has belly pain or spasm associated with a change in the appearance or frequency of their bowel movements. When you have IBS, your colon looks normal, but it does not work the way it should. IBS is a common functional bowel disorder that generates a significant health care burden and can severely impair quality of life and is the most commonly diagnosed gastrointestinal condition.


  • Abdominal Pain or Discomfort
  • Bloating
  • Diarrhea
  • Constipation
  • Fatigue


  • Altered gastrointestinal motility
  • Visceral hypersensitivity
  • Post infectious reactivity
  • Brain-gut interactions
  • Alteration in fecal micro flora
  • Bacterial overgrowth
  • Food sensitivity
  • Carbohydrate malabsorption
  • Intestinal inflammation


See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:

  • Weight loss
  • Diarrhea at night
  • Rectal bleeding
  • Iron deficiency anemia
  • Unexplained vomiting
  • Difficulty swallowing
  • Persistent pain that isn’t relieved by passing gas or a bowel movement


The exact cause of IBS isn’t known. There are many possible causes of IBS, and they differ from person to person. This means that some people can have the same symptoms, but different causes of their IBS. Some experts think that if you have IBS, your colon or small intestine may be more sensitive than normal. That means it has a strong reaction to things that should not normally affect it.

When you have IBS, your colon muscles begin to move and tighten uncontrollably (spasm) after only mild stimulation or after normal events such as:

  • Eating
  • Swelling or bloating from gas or other material in the colon
  • Some medications
  • Some foods
  • Women with IBS seem to have more symptoms during their periods. This could mean that the chemicals (reproductive hormones) released during a woman’s menstrual cycle may increase IBS symptoms.


Symptoms of IBS can be triggered by:

FOOD. The role of food allergy or intolerance in IBS isn’t fully understood. A true food allergy rarely causes IBS. But many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk, and carbonated drinks.
STRESS. Most people with IBS experience worse or more frequent signs and symptoms during periods of increased stress. But while stress may aggravate symptoms, it doesn’t cause them.


Many people have occasional signs and symptoms of IBS. However, risk factor include:

  • IBS occurs more frequently in people under age 50.
  • IBS is more common among women. Estrogen therapy before or after menopause also is a risk factor for IBS.
  • Have a family history of IBS. Genes may play a role, as may shared factors in a family’s environment or a combination of genes and environment.
  • Psychological Stress


Diarrhea and constipation that happen with IBS can cause hemorrhoids. If you already have hemorrhoids, they may get worse.

Your quality of life may be affected by IBS, because the symptoms may limit your daily activities.


Your healthcare provider will decide how much testing you need depending on your age and symptoms. Diagnostic tests may include the following:

  • Blood tests
  • Urinalysis and urine culture
  • Stool culture
  • Stool testing for blood (fecal occult blood test)
  • Upper endoscopy also called EGD (esophagogastroduodenoscopy)
  • Abdominal X-rays
  • Abdominal ultrasound
  • Colonoscopy
  • Breath test. This test may diagnose bacterial overgrowth that some belief can lead to IBS.


  • Low FODMAP Diet


  1. Beef Pasties


  • 300g of gluten free plain flour
  • 1 tsp xanthan gum
  •  1 tsp salt
  • 50g butter
  • 1 egg
  • 1 extra egg for glazing and extra flour for rolling out the pastry
  • 500g of beef skirt
  • 100g of celeriac
  • Fresh Thyme
  • Salt and pepper


  • Add the flour to a bowl and salt and pepper and xanthan gum – stir well into the flour.
  • Cut up the butter into cubes and rub into the flour, add the egg and extra water if required and bring the
  • pastry together knead the pastry till smooth then chill.
  • While the pastry is chilling chop the meat and celeriac into small cubes add the thyme break the second egg
  • into a bowl and whisk.
  • Roll out the pastry in between cling film cut out disks about the size of a small plate.
  • Add a small amount of meat and celeriac and thyme to half the disk add salt and pepper.
  • Brush egg around the pastry edge on the half of the disc with filling bring over the other half of the disk to
  • make the lid and crimp
  • Brush the top of the pastry with egg wash
  • Cook at 165°C
  1. Crustless Quiche


  • 13g/1tbsp garlic infused oil
  • 250g fresh spinach
  • 200g cherry tomatoes
  • 4 eggs
  • 60g gluten free flour
  • 2g/1/2tsp baking powder
  • 4g/1tbsb fresh thyme
  • Salt and pepper to season
  • 300 ml lactose free milk
  • 200g cherry tomatoes
  • 30g cheddar cheese
  • 30g parmesan


  • Preheat oven to 180°C
  • Grease a flan tin/quiche dish.
  • Heat the oil in a separate pan and add the spinach Sauté until wilted stirring all the time, remove from the heat and allow to cool.
  • In a large bowl, mix together the eggs, flour, baking powder and thyme. Season, then whisk in the milk.
  • When the spinach is cooled, chop into small pieces and combine the spinach with the egg mixture.
  • Pour the filling into the prepared tin or dish. Don’t overfill!
  • Top with the tomatoes and both cheeses.
  • Place in the oven and bake for 30-35 minutes or until the quiche has set and turns golden.
  • Garnish with the remaining cherry tomatoes and serve hot or cold.

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.


Procedures & Conditions Treated


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

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.

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.

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.


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.

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.

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.

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.

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.

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