Dr. Denis Michael Petrunia

Dr. Denis Petrunia diagnoses and treats a wide range of digestive system disorders, including:

Esophageal, Stomach & Upper GI Disorders

• Gastritis (Inflammation of Stomach Lining) & Duodenitis: Inflammation of the stomach lining (gastritis) or the first part of the small intestine/duodenum (duodenitis), which can be acute or chronic and caused by various factors including infection, irritants, or autoimmune processes.
• Eosinophilic Esophagitis (EoE): A chronic immune system disease characterized by a buildup of eosinophils (a type of white blood cell) in the esophagus, causing inflammation, difficulty swallowing, food impaction, and chest pain.
• Peptic Ulcer Disease (Gastric, Duodenal, H. pylori-related, NSAID-induced): Open sores that develop on the inside lining of the stomach (gastric ulcer) and the upper portion of the small intestine (duodenal ulcer), commonly caused by H. pylori infection or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Small & Large Intestine (Colorectal) Disorders

• Microscopic Colitis (Lymphocytic & Collagenous Colitis): Inflammation of the colon that is only visible under a microscope when biopsies are examined, a common cause of chronic watery diarrhea, particularly in older adults.
• Gastrointestinal Bleeding (Obscure & Overt): Bleeding anywhere along the digestive tract, which can be visible (overt) or hidden (occult/obscure), requiring investigation to identify and treat the source.
• Irritable Bowel Syndrome (IBS) - All Subtypes (IBS-D, IBS-C, IBS-M, IBS-U): A common functional gastrointestinal disorder affecting the large intestine, causing symptoms like cramping, abdominal pain, bloating, gas, and changes in bowel habits (diarrhea, constipation, or mixed).

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.
• 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.
• Cirrhosis & Management of Its Complications (Ascites, Varices, Encephalopathy): Advanced stage of liver scarring (fibrosis) impairing liver function, leading to complications such as fluid accumulation in the abdomen (ascites), enlarged veins that can bleed (varices), and brain dysfunction (hepatic encephalopathy).

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

• 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.
• 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.
• ERCP (Endoscopic Retrograde Cholangiopancreatography) - Diagnostic & Therapeutic: Specialized procedure combining upper endoscopy and X-rays to diagnose and treat problems of the bile and pancreatic ducts, such as gallstone removal from bile duct, stent placement for strictures or leaks, and sphincterotomy.
• 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.
• Comprehensive Gastroenterology Consultation & Digestive Health Assessment: In-depth assessment of digestive system disorders, including detailed review of medical history, family history, lifestyle factors, physical examination, symptom analysis, and development of a personalized diagnostic and treatment strategy.
• 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.
• Flexible Sigmoidoscopy with Biopsy: Examination of the lower part of the colon (sigmoid colon and rectum) using a flexible sigmoidoscope, often for evaluation of rectal bleeding, diarrhea, or as part of some screening protocols.

Note: This list provides a general overview. Specific procedures and treatments are determined after a thorough evaluation. Discuss with Dr. Petrunia 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.

Denis Petrunia Clinic Victoria is situated in the vibrant neighborhood near central Saanichton. The facility is conveniently accessible via local public transit, making it easy for patients to reach from various parts of the region. The clinic is located in a modern building with parking options including metered street parking and nearby parking lots. The facility is wheelchair accessible, ensuring ease of access for all patients. Local points of interest include community centers, parks, and shopping areas, making visits both comfortable and convenient for residents of Saanichton and surrounding communities.

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

Medically necessary consultations with a licensed Gastroenterologist like Dr. Petrunia, 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. Petrunia'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. Petrunia, 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. Petrunia 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.

Are there significant risks associated with procedures like gastroscopy or colonoscopy?

Gastroscopy (upper endoscopy) and colonoscopy are generally very safe procedures, especially when performed by an experienced Gastroenterologist like Dr. Petrunia. Complications are uncommon. Potential risks can include bleeding, particularly if polyps are removed or biopsies are taken; perforation (a tear in the wall of the digestive tract); infection (rare); or adverse reactions to the sedative medication used. Before your procedure, Dr. Petrunia will thoroughly discuss the specific potential risks and benefits based on your individual health and the reason for the procedure, allowing you to make an informed decision.

What are common reasons someone would be referred to a Gastroenterologist like Dr. Petrunia?

Referral to a Gastroenterologist like Dr. Petrunia 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.

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

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

Yes, a Gastroenterologist like Dr. Petrunia 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.

Denis Petrunia Clinic Victoria
7819 A East Saanich Rd
Saanichton, BC V8M 1A0

Phone: (250) 544-3128 | Fax: (250) 381-9902

The facility is wheelchair accessible.

Dr. Petrunia 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. Petrunia 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/303699/Petrunia%2CDenis