About
Dr. Gregory James Monkewich is a dedicated Gastroenterologist specializing in the diagnosis and treatment of a wide array of disorders affecting the digestive system in adult patients, and may also see older adolescents for certain conditions. Practicing at a gastroenterology clinic or hospital department in North Vancouver, BC, he is a key member of the local medical community. He provides comprehensive care for a wide range of digestive system disorders, including conditions affecting the esophagus, stomach, intestines, liver, and pancreas, utilizing diagnostic and therapeutic endoscopy. His approach focuses on evidence-based practices, ensuring that each patient receives personalized and effective management of their digestive health. The practice is committed to offering patient-centered care in a supportive environment, emphasizing the importance of patient education and ongoing communication.
He holds a medical degree (MD) from the University of Ottawa in Canada and is board-certified as a Gastroenterologist by the Royal College of Physicians and Surgeons of Canada. His certification signifies his expertise and adherence to the highest standards of specialty practice in digestive health care. Throughout his career, Dr. Monkewich has maintained a strong commitment to continuous professional development, staying current with advances in gastroenterology to provide his patients with the most effective treatments available.
Dr. Monkewich’s clinical philosophy centers on delivering evidence-based, compassionate care. He believes in empowering patients through education about their conditions and involving them actively in their treatment plans. His focus is on early and accurate diagnosis using advanced diagnostic procedures, followed by tailored therapeutic strategies to achieve optimal health outcomes. Fluent in both English and French, he is dedicated to serving his diverse patient population in North Vancouver with professionalism and respect.
Dr. Gregory Monkewich diagnoses and treats a wide range of digestive system disorders, including:
Inflammatory Bowel Disease (IBD) Focus
- Indeterminate Colitis & IBD-Unclassified (IBD-U): Cases of IBD, particularly early in the disease course, where it is difficult to definitively distinguish between Crohn's disease and ulcerative colitis based on clinical, endoscopic, and histological features.
- 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.
- Microscopic Colitis (often considered alongside IBD for chronic diarrhea): Though distinct from classic IBD, it's an inflammatory condition of the colon diagnosed by biopsy, causing chronic watery diarrhea.
Liver, Gallbladder, Bile Duct & Pancreatic Disorders
- Autoimmune Liver Diseases (Autoimmune Hepatitis, PBC, PSC): Conditions where the body's immune system mistakenly attacks liver cells (Autoimmune Hepatitis), bile ducts within the liver (Primary Biliary Cholangitis), or larger bile ducts inside and outside the liver (Primary Sclerosing Cholangitis).
- 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.
Esophageal, Stomach & Upper GI Disorders
- Gastroesophageal Reflux Disease (GERD) / Acid Reflux / Heartburn: Chronic condition where stomach acid frequently flows back into the esophagus, causing heartburn, regurgitation, chest pain, and potential complications like esophagitis.
- 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).
- 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.
This list is not exhaustive. For personalized advice regarding your specific digestive condition, please consult with Dr. Gregory Monkewich.
- 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.
- 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.
- 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.
- 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.
- Management of Common & Chronic Digestive Symptoms: Investigating and treating common but potentially disruptive digestive symptoms such as heartburn, acid reflux, bloating, abdominal pain, cramping, excessive gas, constipation, diarrhea, difficulty swallowing (dysphagia), and unexplained weight loss.
- 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.
- Capsule Endoscopy (Small Bowel & Colon): Non-invasive procedure where the patient swallows a vitamin-pill sized camera that takes pictures of the small intestine (for obscure GI bleeding, Crohn's disease) or colon (as an alternative to colonoscopy in select cases).
Note: This list provides a general overview. Specific procedures and treatments are determined after a thorough evaluation. Discuss with Dr. Monkewich 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.
Dr. Monkewich practices within a well-equipped gastroenterology clinic situated in North Vancouver, conveniently located in an area near central North Vancouver. The facility is easily accessible via local public transit, with many bus routes serving the area. It is situated close to local points of interest, making it a convenient choice for residents and visitors alike. The clinic is wheelchair accessible, ensuring ease of access for patients with mobility challenges. Metered street parking and nearby parking lots provide ample options for those arriving by car, facilitating a comfortable and stress-free visit for all patients seeking digestive health care in the North Vancouver community.
- Are consultations and procedures like endoscopies with Dr. Monkewich, a Gastroenterologist, covered by Medical Services Plan (MSP) in BC?
- Medically necessary consultations with a licensed Gastroenterologist like Dr. Monkewich, 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. Monkewich'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. Monkewich, 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. Monkewich 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 Dr. Monkewich approach treating functional GI disorders like IBS or functional dyspepsia?
- Treating functional GI disorders like Irritable Bowel Syndrome (IBS) or functional dyspepsia often involves a multi-faceted approach tailored by Dr. Monkewich to your specific symptoms and triggers. Since these conditions don't have a structural cause seen on tests, management focuses on symptom relief and improving quality of life. This may include dietary modifications (like identifying trigger foods or trying a low FODMAP diet for IBS), lifestyle adjustments (stress management, regular exercise), fiber supplements, over-the-counter remedies, and prescription medications. Medications can target specific symptoms like pain (antispasmodics), diarrhea (anti-diarrheals), constipation (laxatives), or abnormal gut-brain interaction (neuromodulators in low doses). He will work with you to find the most effective combination of strategies.
- How does a Gastroenterologist like Dr. Monkewich approach the management of Inflammatory Bowel Disease (IBD)?
- The management of IBD (Crohn's disease and ulcerative colitis) by a Gastroenterologist like Dr. Monkewich 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 integral parts of comprehensive IBD care.
202-1133 Lonsdale Ave, North Shore Office
North Vancouver, BC V7M 2H4
Phone: (604) 677-1624 | Fax: (604) 677-5883
The facility is wheelchair accessible.
Dr. Monkewich 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. Monkewich 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/324366/Monkewich%2CGregory