Services

Dr. Christian Zalai, MDCM, MSc, FACS, FRCSC, FABCRS

How we can help

Welcome to the West Island Colorectal specialists website!

Our office specializes in managing diseases related to the colon, rectum and anus. We treat cancers of the colon, rectum, and anus as well as other intestinal cancers. We also treat benign conditions such as diverticular disease, inflammatory bowel disease (Crohn’s and colitis), bowel obstructions, and rectal prolapse. We also specialize in perianal conditions such as hemorrhoids, fistulas, anal fissures, condylomas / warts, and skin conditions. Colorectal surgeons are also experts in endoscopic evaluation of the gastrointestinal tract.

We also work with pelvic floor physiotherapists, psychologists, dieticians, and other medical specialists (general surgeons, gastroenterologists, urologists, gynaecologists) to provide optimal care.

In most cases, you will need a referral to see one of our colorectal surgeons. Your family physician or other specialist will evaluate your condition to determine if you need to be seen by a colorectal surgeon. You may call the clinic or request an appointment by email. To facilitate scheduling, please email the referral slip prior to calling the clinic. Alternatively, you may bring your referral slip at the time of your appointment.

Colon and rectal surgeons are specialized in both the operative and non-operative treatment of disorders of the colon, rectum and anus. They have completed additional specialized training in addition to full training in general surgery.

We specialize in the treatment of all the conditions listed below.

Gastrointestinal Bleeding

Bleeding from the digestive tract can range from mild spotting to life-threatening hemorrhage. Most bleeding from the lower digestive tract is due to benign disorders (hemorrhoids, anal fissures, fistulae, skin disorders, etc), but a trained physician is required to evaluate symptoms to ensure a more serious cause of bleeding is ruled out. These can include colorectal cancers, intestinal polyps, diverticular disease.

Anal Cancer

Anal cancer is a type of cancer affecting the skin surrounding the anal canal and can extend inside the anal orifice, which is the distal-most end of the digestive tract.

Colon & Rectal Cancer

Colon and rectal cancer are the 3rd most common types of cancer in Canada. They can develop from small growths called polyps in the large intestine. Most polyps are benign but some can become cancerous over time. Colon and rectal cancer can often be prevented through regular screening tests, including flexible sigmoidoscopy, colonoscopy, FIT testing, and healthy changes in diet and lifestyle.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel diseases consists mainly of two distinct variants :

Crohn’s disease & Ulcerative colitis

Both disorders may require surgery either because medical management is no longer effective, side-effects of treatment are becoming intolerable or because complications from the disease have developed. Complications can include scarring / strictures leading to obstructions, fistulas, bleeding, cancer, intractable weight loss, etc. A specialized physician is recommended for the management of this condition. We specialize in the surgical management of IBD.

ULCERATIVE COLITIS

Ulcerative colitis is a form of IBD. It is similar to Crohn’s disease, but affects only the colon. Inflammation typically begins in the rectum and extends upwards to the beginning of the colon. Severity of disease varies between individuals, with most being managed medically. Although most patients with ulcerative colitis do not require surgery, once the need for surgery arises the care of a specialized surgeon is required. Surgery for ulcerative colitis is typically curative.

CROHN’S DISEASE

Crohn’s disease is a form of IBD. It is similar to ulcerative colitis, but can affect any part of the digestive tract, from the mouth to the anus. Inflammation tends to follow specific patterns and may affect one area more than others. It may also affect areas outside the intestines (such as the liver, skin, joints, or even the eyes). Severity is also highly variable between patients. Surgery for Crohn’s disease is typically reserved for those who are no longer responding to medical treatments or who have developed significant complications from their disease.

Diverticular Disease

Diverticulae are outpouchings of the colon that typically develop over one’s lifetime due to either inadequate water and/or inadequate fibre intake. Obesity is also an important risk factor. There can be a heritable component and some individuals with a strong family history may develop diverticular disease despite a healthy lifestyle. Most patients with diverticular disease do not have symptoms. 10% of patients can develop symptoms related to their diverticulae including pain, inflammation, and infection. Others can develop more serious complications such as life-threatening bleeding, perforations, obstructions and fistulae.

Polyposis Syndromes

Lynch Syndrome (also known as Hereditary non-polyposis colorectal cancer)

FAP (familial adenomatous polyposis syndrome)

aFAP (attenuated familial adenomatous polyposis syndrome)

MutyH polyposis syndrome (MyH polyposis)

Serrated polyposis syndrome (formerly known as hyperplastic polyposis syndrome)

These genetic abnormalities result in increased risk of polyps and colorectal cancers. They are also associated with increased risks of other non-digestive tract cancers. These diseases are typically followed by a multi-disciplinary team consisting of many specialist physicians (surgeons, gastroenterologists, urologists, etc). In conjunction with our specialist colleagues at McGill University, we are able to offer surgical treatment for these conditions.

Anal Fissures

These are rips or tears in the skin lining the anal canal. They are often extremely painful and can take months to heal. They are often caused either by the passage of a hard stool, large flow diarrhea or anoreceptive intercourse. Some anal fissures can be caused by more serious conditions, such as inflammatory bowel disease (IBD), sexually transmitted infections, or even pre-cancerous or cancerous lesions. Most are treated with stool bulking / softening agents, and muscle relaxants. Botox has also been shown to be effective in helping heal anal fissures. A trained professional is required to evaluate these problems.

Anal and Perianal Warts

These are fleshy growths caused by the HPV (human papilloma virus). Typically they can itch, bleed, or interfere with personal hygiene. The virus is usually but not exclusively contracted through sexual contact. Condoms do not completely prevent transmission of this virus, but may reduce the risk somewhat. Most strains only cause warts and these can be treated in the office setting. Some strains cause anal / perianal skin cancers, and / or oropharyngeal (mouth and throat), and / or cervical cancers. A good visual examination is important to diagnose this condition and initiate early treatment.

Hemorrhoids

Hemorrhoids are arterial cushions lining the anal canal. We all have them and they play an important role in preventing involuntary stool loss and cushioning the anus against trauma. Increased straining such as with constipation, pregnancy and childbirth, unhealthy toileting habits or even prolonged, frequent diarrhea may make them bigger. Enlarged hemorrhoids can bleed, contribute to anal leakage making the skin damp, itchy, and irritated. Diagnosing hemorrhoids requires a careful anal evaluation by a specialist as they are often mistaken for other problems in the area.

Fistulas

Fistulas are abnormal connections between two skin-lined structures. They often arise from a perianal abscess. This is an infection near the anus, which can persist and form a tunnel between the anus and perianal skin, resulting in chronic leakage. At this point it is called a fistula. Fistulae can also form between the intestine and the bladder or vagina, resulting in leakage of fecal material from any one of those organs. The most common causes of fistulae are diverticular disease, Crohn’s disease, or cancers of the gastrointestinal tract. Surgical treatment is often required.

Pilonidal Cysts and Sinuses

A pilonidal cyst is a skin infection caused by ingrown hairs that occur at the top of the buttocks. Hair tends to grown inward and tunnel under the skin causing chronic inflammation and occasionally an infection.

Pouchitis

Pouchitis is a condition that can occur after a particular surgery for ulcerative colitis. Ulcerative colitis is a form of inflammatory bowel disease or inflammation of the colon. It is similar to Crohn’s disease, but tends to affect only the colon. Inflammation begins in the rectum and extends to the end of the small intestine. It is associated with different degrees of severity. Although most patients with ulcerative colitis do not require surgery, they require the care of a specialized and trained physician.

Rectal Prolapse

Rectal prolapse involves the exit of all or part of the rectum through the anus. It can affect either the full thickness of the rectal wall or simply the wall (mucosal prolapse). It is often confused with hemorrhoids. The prolapse is often caused by weakening / atrophy of the pelvic floor muscles and ligaments that support the rectum and attach it to the pelvic bones. Individuals at any age can be affected, the disorder tends to afflict older women in particular, especially those who have had a hysterectomy or multiple deliveries and/or those who suffer from chronic constipation or neurological disorders.

Stoma Complications

A stoma is a connection from the intestine to the skin of the abdominal wall. They are created with from the colon (colostomy) or the small bowel (ileostomy). Typically an appliance is placed over the stoma to collect stool and provide a convenient, odor-free disposal mechanism. The presence of an ostomy can lead to certain complications, including skin irritation / breakdown and dehydration.