Dr. Jean-Maxime Picard

Dr. Jean-Maxime Picard diagnoses and treats a wide range of digestive system disorders, including:

Liver, Gallbladder, Bile Duct & Pancreatic Disorders

• 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).
• 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

• 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.
• 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.
• 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.

This list is not exhaustive. For personalized advice regarding your specific digestive condition, please consult with Dr. Jean-Maxime Picard.

• 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.
• 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).
• Biofeedback Therapy Coordination for Pelvic Floor Dysfunction & Fecal Incontinence: Evaluation for defecatory disorders and fecal incontinence, with coordination of biofeedback therapy and other interventions to improve pelvic floor muscle function.
• 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.
• 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 Chronic Constipation & Chronic Diarrhea (idiopathic & secondary): Systematic investigation into underlying causes (including motility testing where appropriate) and tailored treatment strategies for persistent constipation or diarrhea not attributed to other major GI diseases.
• 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. Picard 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.

Dr. Jean-Maxime Picard's practice is situated within the CIUSSS de Chicoutimi, located in the vibrant area near central Chicoutimi. The facility is conveniently accessible via local public transit, making it easy for patients from various parts of the city and surrounding regions to attend appointments. The practice is housed in a modern, wheelchair-accessible building, ensuring comfortable access for all patients. Metered street parking and nearby parking lots are available for those arriving by car, providing flexible options for visitors. The practice's location is close to several local points of interest, including community centers and public parks, fostering a welcoming environment for patients and their families.

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

Medically necessary consultations with a licensed Gastroenterologist like Dr. Picard, 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. Picard'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. Picard, 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. Picard 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. Picard. 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. Picard 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 some common procedures a Gastroenterologist like Dr. Picard typically performs?

Gastroenterologists like Dr. Picard 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.

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

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. Picard 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. Picard diagnose and treat both?

Yes, a Gastroenterologist like Dr. Picard 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.

CIUSSS de Chicoutimi
305 rue Saint-Vallier
Chicoutimi, QC G7H 5H6

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

The facility is wheelchair accessible.

Dr. Picard 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. Picard 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=15268