Dr. William Allan Appell

Dr. William Appell diagnoses and treats a wide range of digestive system disorders, including:

Functional Gastrointestinal & Motility Disorders

• Cyclic Vomiting Syndrome: A disorder characterized by recurrent, stereotypical episodes of intense nausea and vomiting lasting for hours or days, with symptom-free intervals in between.
• Gastroparesis (Delayed Gastric Emptying): A condition that affects the normal spontaneous movement of the muscles (motility) in your stomach, preventing proper and timely emptying of stomach contents, leading to nausea, vomiting, and fullness.
• 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.

Small & Large Intestine (Colorectal) Disorders

• 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.
• 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.

Inflammatory Bowel Disease (IBD) Focus

• 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.

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

• 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.
• 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.
• 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.
• 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.
• 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.

Note: This list provides a general overview. Specific procedures and treatments are determined after a thorough evaluation. Discuss with Dr. Appell 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 Ontario (CPSO) and relevant gastroenterological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

Dr. William Allan Appell's practice is located within a reputable gastroenterology clinic in Toronto’s Woodbine Heights neighborhood. The facility is conveniently situated near the US Consulate, making it easily accessible for both local and international patients. Public transit options, including TTC (Subway, Streetcar, Bus), serve the area, ensuring convenient travel. The practice location is fully wheelchair accessible, and paid parking options are conveniently located nearby, facilitating easy access for all patients.

Are consultations and procedures like endoscopies with Dr. Appell, a Gastroenterologist, covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary consultations with a licensed Gastroenterologist like Dr. Appell, 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 Ontario Health Insurance Plan (OHIP) in ON 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. Appell's office, the hospital/clinic's financial services, or Ontario Health Insurance Plan (OHIP) beforehand.

Do I need a referral from my family doctor to see Dr. Appell, 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. Appell 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.

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

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. Appell 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 is generally involved in preparing for a colonoscopy procedure?

Preparing for a colonoscopy is a critical step to ensure the procedure is effective and safe. Dr. Dr. Appell's office will provide very specific instructions, which must be followed closely. Typically, preparation involves dietary changes for a few days beforehand (e.g., low-residue diet), followed by a clear liquid diet for the 24 hours prior to the exam. The most important part is the bowel cleansing process, which involves drinking a prescribed laxative solution designed to completely empty and clean your colon. This usually starts the evening before and may continue the morning of the procedure. You'll also need to arrange for transportation home, as sedation is commonly used.

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

Referral to a Gastroenterologist like Dr. Dr. Appell 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.

Suite 402, 840 Coxwell Avenue
Toronto, ON M4C 5T2

Phone: (416) 690-6762 | Fax: (416) 690-6775

The facility is wheelchair accessible.

Dr. Appell is a licensed Gastroenterologist regulated by the College of Physicians and Surgeons of Ontario (CPSO) under the Regulated Health Professions Act, 1991 and Medicine Act, 1991 in ON. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Appell for services covered by the provincial health plan.

Verify registration with the College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Appell-William-Allan/0027629-32452