Dr. Josiane Nawar

Dr. Josiane Nawar diagnoses and treats a wide range of digestive system disorders, including:

Small & Large Intestine (Colorectal) Disorders

• 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.
• 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.

Esophageal, Stomach & Upper GI Disorders

• 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).
• 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.

Functional Gastrointestinal & Motility Disorders

• 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.
• Rumination Syndrome: A condition in which people repeatedly and unintentionally spit up (regurgitate) undigested or partially digested food from the stomach, rechew it, and then reswallow it or spit it out.
• Functional Dyspepsia & Epigastric Pain Syndrome: Persistent or recurrent pain or discomfort centered in the upper abdomen (dyspepsia) or specifically in the epigastric region, without an identifiable structural cause after investigation.

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

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.

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

Hôpital de la Cité de la santé de Laval is situated in Laval's Chomedey North neighborhood, serving as a key medical facility within the hospital complex. The hospital is conveniently accessible via public transit, with the Station de la Concorde (Metro/exo) and Parc des Prairies nearby, making it easy for patients to reach the facility. The hospital is part of the larger healthcare network managed by the Société de transport de Laval (STL). The facility is wheelchair accessible, ensuring ease of access for all patients. Metered street parking and nearby parking lots are available to accommodate visitors, making it convenient for patients to attend appointments and procedures.

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

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

What are some common procedures a Gastroenterologist like Dr. Nawar typically performs?

Gastroenterologists like Dr. Nawar 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, She 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.

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

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

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

Yes, a Gastroenterologist like Dr. Nawar 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.

Hôpital de la Cité de la santé de Laval
1755 boul René-Laennec
Laval, QC H7M 3L9

Phone: (450) 668-1010

The facility is wheelchair accessible.

Dr. Nawar 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. Nawar 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=14283