Dr. Alban Michaud-Herbst

Dr. Alban Michaud-Herbst diagnoses and treats a wide range of digestive system disorders, including:

Liver, Gallbladder, Bile Duct & Pancreatic Disorders

• Pancreatic Cysts, Tumors & Pancreatic Insufficiency (Evaluation & Co-management): Evaluation of fluid-filled sacs (cysts) or growths (tumors) on or in the pancreas, and management of exocrine pancreatic insufficiency (EPI) where the pancreas doesn't produce enough digestive enzymes.
• Alcohol-Related Liver Disease (ARLD): Liver damage caused by excessive alcohol consumption, ranging from fatty liver and alcoholic hepatitis to advanced cirrhosis.
• Chronic Viral Hepatitis (Hepatitis B, C, D): Long-term viral infections that cause inflammation and damage to the liver, potentially leading to cirrhosis, liver failure, or liver cancer if untreated.

Inflammatory Bowel Disease (IBD) Focus

• Ulcerative Colitis (Proctitis, Left-sided Colitis, Pancolitis): A chronic inflammatory condition that causes inflammation and ulcers primarily in the lining of the large intestine (colon and rectum), typically presenting with bloody diarrhea, urgency, and abdominal pain.
• Crohn's Disease (Ileal, Colonic, Ileocolonic, Perianal): A chronic inflammatory condition that can affect any part of the digestive tract from mouth to anus, causing transmural (full-thickness) inflammation, pain, diarrhea, weight loss, and potential complications like strictures or fistulas.

Functional Gastrointestinal & Motility Disorders

• Pelvic Floor Dysfunction & Anorectal Disorders (e.g., Dyssynergic Defecation): Inability to correctly relax and coordinate pelvic floor muscles to facilitate a normal bowel movement, often requiring specialized testing like anorectal manometry and biofeedback therapy.
• Chronic Idiopathic Constipation (CIC) & Opioid-Induced Constipation (OIC): Persistent constipation that does not have an identifiable underlying cause (CIC) or is a side effect of opioid medications (OIC).

This list is not exhaustive. For personalized advice regarding your specific digestive condition, please consult with Dr. Alban Michaud-Herbst.

• Personalized Nutritional Assessment & Medical Dietary Therapy for GI Conditions: Evaluation of nutritional status and provision of evidence-based dietary advice and medical nutrition therapy tailored to specific gastrointestinal disorders like IBD, IBS, celiac disease, eosinophilic esophagitis, gastroparesis, or food intolerances, often in collaboration with registered dietitians.
• Endoscopic Hemostasis for Acute & Chronic GI Bleeding: Various endoscopic techniques (e.g., injection therapy, thermal coagulation/APC, mechanical clips, hemostatic sprays) used to stop acute or recurrent bleeding from ulcers, varices, angiodysplasias, or tumors in the GI tract.
• Enteroscopy (e.g., Double-Balloon, Single-Balloon, Spiral Enteroscopy): Advanced endoscopic techniques allowing deep visualization, biopsy, and therapy within the small intestine, beyond the reach of standard endoscopes, for conditions like obscure bleeding or small bowel tumors.
• Colonoscopy (Screening, Diagnostic, Surveillance) & Polypectomy: Comprehensive examination of the entire colon (large intestine) using a colonoscope to detect and remove precancerous polyps, screen for and diagnose colorectal cancer, evaluate symptoms, and diagnose other colonic conditions like colitis or diverticular disease.
• Endoscopic Dilation of Gastrointestinal Strictures (Esophageal, Pyloric, Colonic): Procedure to stretch narrowed areas (strictures) in the esophagus (e.g., due to reflux, EoE), stomach outlet (pylorus), small intestine, or colon using balloons or Savary-Gilliard dilators passed through an endoscope.
• Second Opinion Consultations for Complex Digestive Diseases: Providing expert second opinions on challenging or rare gastrointestinal diagnoses, unclear test results, and proposed complex treatment plans, including for IBD, liver disease, and pancreatic disorders.
• Helicobacter pylori (H. pylori) Testing & Eradication Therapy: Diagnosis of H. pylori infection using breath tests, stool tests, or endoscopic biopsies, and providing appropriate antibiotic regimens for eradication to treat ulcers and gastritis.

Note: This list provides a general overview. Specific procedures and treatments are determined after a thorough evaluation. Discuss with Dr. Michaud-Herbst for care relevant to your specific condition.

All medical and surgical services (if applicable) are provided in accordance with the standards of practice set by the Collège des médecins du Québec (CMQ) and relevant gastroenterological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

CSSSde Chicoutimi is situated in Chicoutimi, QC, in an area near central Chicoutimi that is easily accessible for patients. The facility is located close to local points of interest and is well-served by public transit, making it convenient for patients traveling from various parts of the city. The building is wheelchair accessible, ensuring ease of access for all patients. Parking is available at or near the facility, providing a stress-free experience for visitors seeking specialized digestive health care in a comfortable environment.

Are consultations and procedures like endoscopies with Dr. Michaud-Herbst, a Gastroenterologist, covered by Régie de l'assurance maladie du Québec (RAMQ) in QC?

Medically necessary consultations with a licensed Gastroenterologist like Dr. Michaud-Herbst, as well as most diagnostic procedures (e.g., endoscopies for investigating symptoms, biopsies for medical reasons) and treatments for provincially insured digestive conditions (e.g., IBD, celiac disease, screening colonoscopies as per provincial guidelines, liver disease management), are generally covered by Régie de l'assurance maladie du Québec (RAMQ) in QC when a referral from a family doctor or another specialist is in place. Procedures considered purely for screening outside of guidelines, or for non-medical reasons, and some advanced technologies or specific drug therapies might have different coverage. It's crucial to discuss coverage specifics for any proposed treatment or procedure with Dr. Michaud-Herbst's office, the hospital/clinic's financial services, or Régie de l'assurance maladie du Québec (RAMQ) beforehand.

Do I need a referral from my family doctor to see Dr. Michaud-Herbst, a Gastroenterologist?

Yes, in nearly all cases, a referral from your family physician or another specialist (such as an internist or surgeon) is required to schedule an appointment with a Gastroenterologist like Dr. Michaud-Herbst for services covered by the provincial health plan. Gastroenterological issues often require initial assessment and preliminary investigations by your primary care provider. The referral ensures that a specialist consultation is appropriate, helps with prioritizing appointments, and facilitates coordinated care, including the transfer of relevant medical information.

How does a Gastroenterologist like Dr. Michaud-Herbst approach the management of Inflammatory Bowel Disease (IBD)?

The management of IBD (Crohn's disease and ulcerative colitis) by a Gastroenterologist like Dr. Michaud-Herbst is a highly individualized and long-term process. The primary goals are to induce and then maintain remission (control inflammation), alleviate symptoms, prevent complications, and improve the patient's overall quality of life. Treatment strategies often involve a combination of medications, which can include aminosalicylates (5-ASAs), corticosteroids (for acute flare-ups), immunomodulators (e.g., azathioprine, methotrexate), and increasingly, biologic therapies or small molecule drugs that target specific inflammatory pathways. Regular monitoring through clinical assessment, blood tests, stool tests (like fecal calprotectin), and endoscopic procedures is crucial to track disease activity and adjust treatment as needed. Nutritional counseling and lifestyle advice are also an integral part of comprehensive IBD care.

What are some common procedures a Gastroenterologist like Dr. Michaud-Herbst typically performs?

Gastroenterologists like Dr. Michaud-Herbst are highly skilled in performing a range of endoscopic procedures. The most common are upper endoscopy (also called EGD or gastroscopy) to examine the esophagus, stomach, and duodenum, and colonoscopy to visualize the entire colon. During these procedures, He can take biopsies (small tissue samples for analysis), remove polyps (which can prevent colon cancer), dilate narrowed areas (strictures), control bleeding, and place feeding tubes. Other procedures may include flexible sigmoidoscopy (examining the lower colon), capsule endoscopy (swallowing a tiny camera to see the small intestine), and more specialized interventions like ERCP or EUS depending on their training and practice focus. Many also specialize in managing specific areas like hepatology (liver disease) or IBD.

What are common reasons someone would be referred to a Gastroenterologist like Dr. Michaud-Herbst?

Referral to a Gastroenterologist like Dr. Michaud-Herbst is common for various reasons, including: persistent heartburn or acid reflux (GERD); difficulty or pain when swallowing; unexplained abdominal pain or bloating; chronic nausea or vomiting; significant changes in bowel habits (e.g., chronic diarrhea, severe constipation); blood in the stool or rectal bleeding; iron deficiency anemia with no obvious cause; suspected or diagnosed Inflammatory Bowel Disease (Crohn's disease, ulcerative colitis); Irritable Bowel Syndrome (IBS) not responding to initial management; celiac disease; abnormal liver function tests or suspected liver disease (like hepatitis or fatty liver); pancreatitis; or for screening and surveillance colonoscopies to prevent colorectal cancer, especially if there's a family history or personal history of polyps.

What's the difference between Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)? Can Dr. Michaud-Herbst diagnose and treat both?

Yes, a Gastroenterologist like Dr. Michaud-Herbst can diagnose and treat both IBS and IBD, but they are very different conditions. IBD, which includes Crohn's disease and ulcerative colitis, is characterized by chronic inflammation and physical damage (like ulcers and strictures) to the digestive tract, visible during endoscopy and on biopsies. It's an autoimmune-related condition. IBS, on the other hand, is a functional gut disorder, meaning the GI tract doesn't work correctly, but there's no visible inflammation or damage on standard tests. IBS causes symptoms like abdominal pain, bloating, and altered bowel habits. While IBS can significantly impact quality of life, it doesn't cause the destructive inflammation seen in IBD. Diagnosis involves different criteria and investigations for each.

CSSSde Chicoutimi
305 rue Saint-Vallier, CP 5006
Chicoutimi, QC G7H 5H6

Phone: (418) 541-1000 | Fax: (418) 541-1190

The facility is wheelchair accessible.

Dr. Michaud-Herbst is a licensed Gastroenterologist regulated by the Collège des médecins du Québec (CMQ) under the Medical Act in QC. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Michaud-Herbst for services covered by the provincial health plan.

Verify registration with the Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=14287