Dr. Brian Lewis Bressler

Dr. Brian Bressler diagnoses and treats a wide range of digestive system disorders, including:

Esophageal, Stomach & Upper GI Disorders

• Hiatal Hernia & Paraesophageal Hernia: Condition where part of the stomach pushes upward through an opening (hiatus) in the diaphragm into the chest, potentially contributing to GERD and other symptoms.
• Barrett's Esophagus & Dysplasia Monitoring: A precancerous condition in which the normal lining of the esophagus is replaced with tissue similar to the intestinal lining, often due to chronic GERD, requiring regular surveillance for dysplasia (abnormal cells).
• Esophageal Motility Disorders (e.g., Achalasia, Esophageal Spasms, Nutcracker Esophagus): Disorders affecting the coordinated muscle movements of the esophagus required for swallowing, leading to symptoms like dysphagia (difficulty swallowing), chest pain, and regurgitation.

Small & Large Intestine (Colorectal) Disorders

• Ischemic Colitis: Inflammation and injury of the large intestine that results from inadequate blood flow.
• Diverticular Disease (Diverticulosis, Diverticulitis, Diverticular Bleeding): Diverticulosis is the presence of small pouches (diverticula) in the colon wall. Diverticulitis is inflammation or infection of these pouches. Diverticular bleeding can also occur.
• Small Intestinal Bacterial Overgrowth (SIBO) & Intestinal Methanogen Overgrowth (IMO): An abnormal increase in the bacterial population in the small intestine, or an overgrowth of methane-producing archaea, leading to symptoms like bloating, gas, abdominal pain, and altered bowel habits.

Functional Gastrointestinal & Motility Disorders

• 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).
• 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.

This list is not exhaustive. For personalized advice regarding your specific digestive condition, please consult with Dr. Brian Bressler.

• 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.
• Irritable Bowel Syndrome (IBS) Comprehensive Diagnosis & Management (including subtypes IBS-D, IBS-C, IBS-M): Multifaceted approach to managing IBS symptoms (abdominal pain, bloating, diarrhea, constipation, mixed pattern) including thorough exclusion of other conditions, dietary modifications (e.g., low FODMAP diet), lifestyle changes, stress management, and targeted medications.
• Upper Endoscopy (EGD - Esophagogastroduodenoscopy) with Biopsy & Interventions: Diagnostic and therapeutic procedure to examine the esophagus, stomach, and duodenum using a flexible tube with a camera. Allows for targeted biopsies, polyp removal (polypectomy), dilation of strictures, control of bleeding (hemostasis), and foreign body removal.
• Interpretation & Correlation of Advanced Digestive Health Diagnostic Tests: Expert analysis and clinical correlation of results from endoscopies, biopsies, imaging studies (CT, MRI, MRCP, ultrasound), breath tests (e.g., for H. pylori, SIBO, lactose intolerance), stool tests (e.g., calprotectin, FIT), motility studies, and genetic testing for GI conditions.
• Endoscopic Ultrasound (EUS) with Fine Needle Aspiration/Biopsy (FNA/FNB): Procedure combining endoscopy with ultrasound to obtain high-resolution images and tissue samples (FNA/FNB) of the digestive tract wall, surrounding organs (pancreas, liver, adrenal glands, gallbladder), and lymph nodes for staging cancers or diagnosing lesions.
• Screening & Prevention Strategies for Gastrointestinal Cancers: Risk assessment and counseling on screening for colorectal cancer, esophageal cancer (in Barrett's esophagus), gastric cancer, and liver cancer (in cirrhosis), including FIT testing and colonoscopy recommendations.
• Chromoendoscopy & Advanced Imaging Techniques (e.g., NBI, FICE): Use of special dye sprays (chromoendoscopy) or electronic light filters (Narrow Band Imaging, Fuji Intelligent Chromo Endoscopy) during endoscopy to enhance visualization of mucosal patterns and improve detection of subtle lesions or precancerous changes.

Note: This list provides a general overview. Specific procedures and treatments are determined after a thorough evaluation. Discuss with Dr. Bressler 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 College of Physicians and Surgeons of British Columbia (CPSBC) and relevant gastroenterological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

St. Paul's Hospital is situated in Vancouver's Yaletown, Downtown South neighborhood, serving as a vital medical facility within the Woodward's Building. The hospital is easily accessible via public transit, including TransLink’s SkyTrain Expo, Millennium, and Canada Lines, as well as bus, SeaBus, and West Coast Express (Waterfront). The facility is wheelchair accessible, ensuring ease of access for all patients. Parking is available at or near the hospital, providing convenient options for those arriving by car. As a key component of Vancouver’s healthcare infrastructure, St. Paul's Hospital offers specialized services and is dedicated to providing comprehensive, patient-focused digestive health care in a supportive environment.

Are consultations and procedures like endoscopies with Dr. Bressler, a Gastroenterologist, covered by Medical Services Plan (MSP) in BC?

Medically necessary consultations with a licensed Gastroenterologist like Dr. Bressler, 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 Medical Services Plan (MSP) in BC 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. Bressler's office, the hospital/clinic's financial services, or Medical Services Plan (MSP) beforehand.

Do I need a referral from my family doctor to see Dr. Bressler, 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. Bressler 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.

Will I be asleep for my endoscopy or colonoscopy with Dr. Bressler?

For most endoscopic procedures like upper endoscopy (gastroscopy) and colonoscopy, patients are typically given sedation to help them relax and be comfortable. This is often called 'conscious sedation' or 'moderate sedation,' meaning you'll be drowsy and may not remember much of the procedure, but you won't be under general anesthesia (completely unconscious with a breathing tube). The specific type and level of sedation can vary and will be discussed with you by Dr. Bressler or the anesthesia provider beforehand. Because of the sedation, you will need to have someone accompany you to drive you home after the procedure.

What is generally involved in preparing for a colonoscopy procedure?

Preparing for a colonoscopy is a critical step to ensure the procedure is effective and safe. Dr. Bressler's office will provide very specific instructions, which must be followed closely. Typically, preparation involves dietary changes for a few days beforehand (e.g., low-residue diet), followed by a clear liquid diet for the 24 hours prior to the exam. The most important part is the bowel cleansing process, which involves drinking a prescribed laxative solution designed to completely empty and clean your colon. This usually starts the evening before and may continue the morning of the procedure. You'll also need to arrange for transportation home, as sedation is commonly used.

St. Paul's Hospital
770-1190 Hornby St
Vancouver, BC V6Z 2K5

Phone: (604) 688-6332 | Fax: (604) 689-2004

The facility is wheelchair accessible.

Dr. Bressler is a licensed Gastroenterologist regulated by the College of Physicians and Surgeons of British Columbia (CPSBC) under the Health Professions Act in BC. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Bressler for services covered by the provincial health plan.

Verify registration with the College of Physicians and Surgeons of British Columbia (CPSBC): https://www.cpsbc.ca/public/registrant-directory/search-result/330677/Bressler%2CBrian