Dr. James Rienk Gray – Gastroenterologist | Vancouver, BC

Dr. James Rienk Gray 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 Vancouver General Hospital in 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 practice is committed to delivering patient-centered digestive health care, emphasizing accurate diagnosis and personalized treatment plans within a supportive environment.

He graduated with a Medical Degree from the University of British Columbia (Canada) and holds specialty certification as a Gastroenterologist. Additionally, he has obtained certifications including the Royal College of Physicians and Surgeons of Canada, and Certification in the College of Family Physicians of Canada. These credentials reflect his commitment to maintaining the highest standards in medical practice and continuous professional development.

Dr. Gray's clinical philosophy centers on evidence-based digestive health care, emphasizing patient education about GI conditions and lifestyle modifications. He prioritizes early and accurate diagnosis through advanced endoscopic and diagnostic procedures, and develops personalized treatment strategies tailored to each patient’s unique needs. His dedication to providing high-quality, compassionate care makes him a trusted provider for residents of Vancouver seeking expert management of digestive health concerns.

Dr. James Gray diagnoses and treats a wide range of digestive system disorders, including:

Inflammatory Bowel Disease (IBD) Focus

• 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.
• 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.

Small & Large Intestine (Colorectal) Disorders

• 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).
• Celiac Disease & Gluten Sensitivity: Celiac disease is an autoimmune disorder triggered by gluten ingestion, damaging the small intestine. Non-celiac gluten sensitivity involves GI symptoms related to gluten without the autoimmune damage.
• 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.

Liver, Gallbladder, Bile Duct & Pancreatic Disorders

• Pancreatitis (Acute Recurrent & Chronic): Inflammation of the pancreas that can be sudden and severe (acute), recurrent, or long-lasting (chronic), causing significant abdominal pain and digestive enzyme deficiencies.
• Non-Alcoholic Fatty Liver Disease (NAFLD) & Non-Alcoholic Steatohepatitis (NASH): A spectrum of conditions characterized by excessive fat accumulation in the liver not caused by alcohol. NASH involves liver inflammation and cell damage and can progress to cirrhosis.

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

• 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.
• 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.
• 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.
• 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.
• 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).
• Gastrointestinal Motility Disorder Evaluation & Management Coordination: Initial evaluation of symptoms suggestive of GI motility disorders (e.g., gastroparesis, achalasia, chronic intestinal pseudo-obstruction), with coordination for specialized testing like esophageal manometry, antroduodenal manometry, wireless motility capsule, or gastric emptying studies, and subsequent management strategies.
• 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.

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

Vancouver General Hospital, located in Vancouver's Fairview neighbourhood, serves as a major medical hub in British Columbia. The Gastroenterology unit is situated within this prominent hospital, providing access to advanced diagnostic and treatment services. The hospital is conveniently accessible via public transit, including TransLink's SkyTrain Expo, Millennium, and Canada Lines, as well as bus, SeaBus, and West Coast Express - Waterfront services. The facility is wheelchair accessible, ensuring easy access for all patients. Parking options include metered street parking and nearby lots, making visits convenient for patients from across the region. Vancouver General Hospital plays a vital role in delivering specialized care to the community and supporting the needs of patients requiring advanced digestive health services.

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

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

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. Gray. 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. Gray 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.

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

The management of IBD (Crohn's disease and ulcerative colitis) by a Gastroenterologist like Dr. Gray 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.

Vancouver General Hospital
5153-2775 Laurel St, Div of Gastroenterology, Vancouver General Hospital
Vancouver, BC V5Z 1M9

Phone: (604) 875-5618 | Fax: (604) 628-2419

The facility is wheelchair accessible.

Dr. Gray 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. Gray 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/349131/Gray%2CJames