Dr. Justina Sam

Dr. Justina Sam is a general gastroenterologist. She sees patients with gastrointestinal issues and performs gastroscopies and colonoscopies. She graduated Summa Cum Laude from the Bachelor of Health Sciences (Honours) Program at McMaster University. She speaks Cantonese and English and some Mandarin. She is accepting new patients.

General FAQ

    I am a new patient of Dr. Sam. What do I need to prepare for my first visit ?
    • Dr. Sam will have an in-person consultation with you at the clinic for your first visit. 
    • After first consultation, if necessary, Dr. Sam will arrange Endoscopy (Gastroscopy/Colonoscopy/Sigmoidoscopy) for you. The procedure will be conducted at the Dynamic Medical Centre. 
    • Dynamic Medical Centre (DMC) will contact you in about 2-3 weeks’ time for your appointment after receiving Dr. Sam’s referral. 
    • For any change or cancellation of appointment with DMC, you need to call directly at 416-222-5501. 
    Gastroscopy/Colonoscopy Preparation Sheet

    Please see Dr. Sam’s preparation sheet (English and Chinese versions available).  If you have further questions about the procedure, please contact Dr. Sam’s office (416-222-5501).

    Endoscopy Clinic Locations
    • Dynamic Medical Centre (5734 Yonge Street, 3rd Floor) at Yonge St. and Finch Ave. East (across from Finch subway station). Parking is free for 3 hours.  There is parking at the back of the building (enter from Yonge St.) Inform the parking attendant that you are seeing Dr. Sam at Dynamic Medical Centre and please register your license plate with the front staff when you get here.  Do not pay for parking in the parking meter.  www.dmchealth.ca
    • Dynamic Medical Centre is under a different operation. Please contact DMC directly for any enquiry including appointment change or cancellation 416-222-5501.
    This program is fully funded by OHIP

    This procedure is fully funded by OHIP. Please remember to bring your OHIP card to the appointment.

    Cancellation Fee

    Please note that there is a cancellation fee of $100 if you do not show up for the appointment or if you cancel less than 3 business days before the test.

    Gastroscopy

      What is gastroscopy?

      A gastroscopy is a procedure where a long tube with a camera on the end is used to assess the lining of the upper digestive tract, which includes the esophagus, stomach, and the duodenum.

      How should I prepare for a gastroscopy?
      • Do not eat or drink after midnight.  However, you can have sips of clear fluids until 4 hours prior to the procedure.
      • You can take your prescribed medications (as outlined by your doctor) with a small sip of water up until 2 hours prior to the procedure.
      • Arrange for a friend or family member to take you home after the procedure.  We cannot provide sedation unless you have someone to accompany you home.  You cannot drive or operate any heavy machinery for the rest of the day after receiving sedation.
      • You may be asked to adjust the dose of your medications (e.g. insulin/other diabetic medications) – if you have questions, please contact Dr. Sam’s office (416-222-0660).
      • If you are taking blood thinning medications, please check with your prescribing physician if and when these medications can be stopped for the endoscopic procedure.
      • When you arrive for the procedure, you will check-in at the front desk of the endoscopy clinic.
      • You will fill out a questionnaire about your past medical history, previous surgical history and medications and allergies ***PLEASE BRING YOUR LIST OF MEDICATIONS
      • You will meet our nurse.  You will be asked to change into a gown.  Please do not bring any valuable belongings.  Your belongings will be placed under your stretcher.
      • An intravenous (IV) needle will be inserted into your arm or hand.  This will be used to provide medication during the procedure.
      What happens during a gastroscopy?
      • The procedure typically takes about 10-20 minutes to complete.
      • Our anesthetist will provide you with medication through the IV so that you will sleep during the procedure.
      • A plastic mouth guard will be used to protect your teeth.
      • You will get oxygen through the nasal prongs during the procedure.  You will get attached to a monitor to assess your heart rate and rhythm, oxygen status and blood pressure throughout the procedure.
      • A flexible tube with a camera on the end with be inserted into your mouth and passed down your esophagus, stomach and duodenum.
      • The doctor may take biopsies (small samples of tissue from the lining of the digestive tract) to send for histologic analysis to help make a diagnosis (e.g. biopsies of the stomach for H. pylori).
      What happens after a gastroscopy?
      • After your test, you will be observed in the recovery area by our nurse until the sedative medication wears off.
      • Once you have met the discharge criteria, you will be able to go home.  Prior to leaving, Dr. Sam will speak to you and give you a sheet of paper with pertinent details about the findings.  If biopsies have been taken, it will take several weeks for the results to return.  Your family doctor (or the referring doctor) will also receive a copy of the report and any biopsy results.
      • Do not return to work on the day of the procedure.
      • Do not drive a vehicle or operate machinery until the day after your procedure.

      Colonoscopy

        What is a colonoscopy?

        A colonoscopy is a procedure where a long tube with a camera on the end is used to assess the lining of the large intestine (colon).

        How should I prepare for a colonoscopy?
        • Buy: 4 DULCOLAX (Bisacodyl) tablets (5 mg each) and a container of polyethylene glycol bowel prep (e.g. PEGLYTE 4 LITRES) – it will come in a jug with powder which you will reconstitute with water.
        • 1 week before the test: Stop taking vitamins, iron, calcium
        • 3 days before the test: Do not eat any uncooked fruits, vegetables, whole bran bread or high fibre cereals or food with seeds
        • 1 day before the test: DO NOT EAT ANY SOLID FOOD THE DAY BEFORE YOUR COLONOSCOPY.  DRINK CLEAR FLUIDS (E.G. water, ginger ale, clear broth, Jell-O, apple or white grape juice, etc.)
          • Reconstitute the PEGLYTE into 4 L as directed
          • You may take Gravol before starting the bowel preparation; you can refrigerate the prep and also add some lemon juice to the prep to a make it more palatable and drink from a straw.
        • At 2 PM the day before the test: take 4 Dulcolax tablets with 1 glass of water.  Drink 3 LITRES of the PEGLYTE between 4PM-10 PM.  You may have additional clear fluids until bedtime.  On the day of the procedure, finish the 4th LITRE (about 4 glasses) of PEGLYTE between 4-6 hours before the appointment time.  
        • It is important to have this “split bowel preparation” as studies have shown a cleaner bowel preparation which will allow for better visualization of your colon.
        • You may have additional clear fluids up to 4 hours before your test.
        • You can take your prescribed medications (as outlined by your doctor) with a small sip of water up until 2 hours prior to the procedure.  Take only the essential medications (e.g. anti-seizure medications, blood pressure medications, etc).
        • Arrange for a friend or family member to take you home after the procedure.  We cannot provide sedation unless you have someone to accompany you home.  You cannot drive or operate any heavy machinery for the rest of the day after receiving sedation.
        • You may be asked to adjust the dose of your medications (e.g. insulin/other diabetic medications) – if you have questions, please contact Dr. Sam’s office (416-222-0660).
        • If you are taking blood thinning medications, please check with your prescribing physician if and when these medications can be stopped for the endoscopic procedure.

         

        • When you arrive for the procedure, you will check-in at the front desk of the endoscopy clinic.
        • You will fill out a questionnaire about your past medical history, previous surgical history and medications and allergies ***PLEASE BRING YOUR LIST OF MEDICATIONS
        • You will meet our nurse.  You will be asked to change into a gown.  Please do not bring any valuable belongings.  Your belongings will be placed under your stretcher.
        • An intravenous (IV) needle will be inserted into your arm or hand.  This will be used to provide medication during the procedure.
        What happens during a colonoscopy?
        • The procedure typically takes about 20-30 minutes to complete but can take longer.
        • Our anesthetist will provide you with medication through the IV so you will sleep during the procedure.
        • You will get oxygen through the nasal prongs during the procedure.  You will get attached to a monitor to assess your heart rate and rhythm, oxygen status and blood pressure throughout the procedure.
        • A flexible tube with a camera on the end with be inserted into your anus and up into the rectum and large bowel.  Your doctor will look at the inside lining of your colon.  In order to do so, air will be pumped into the colon through the tube to inflate the colon.
        • The doctor may take biopsies (small samples of tissue from the lining of the digestive tract) to send for histologic analysis to help make a diagnosis.  Polyps (growths in the colon that can potentially grow and lead to colon cancer) may be removed during the procedure if seen.
        What happens after a colonoscopy?
        • After your test, you will be observed in the recovery area by our nurse until the sedative medication wears off.
        • Once you have met the discharge criteria, you will be able to go home.  Prior to leaving, Dr. Sam will speak to you and give you a sheet of paper with pertinent details about the findings and any important instructions.  If any tissue was taken for analysis, it will take several weeks for the results to return.  Your family doctor (or the referring doctor) will also receive a copy of the report and any pathology results.
        • You may feel bloated after the procedure.  This is common and the feeling usually goes away, especially when you start to pass gas or walk around.
        • Do not return to work on the day of the procedure.
        • Do not drive a vehicle or operate machinery until the day after your procedure.
        • You may eat normally after the procedure.

        Sigmoidoscopy

          What is a flexible Sigmoidoscopy?

          A sigmoidoscopy is a test to examine the lower part of your large bowel (colon) using a flexible camera.

          How should I prepare for a Sigmoidoscopy?
          • FLEET ENEMA PREPARATION: Go to the pharmacy and purchase TWO (2) Fleet ENEMAS1. Starting at 11 PM the night before the procedure, do not have anything to eat. You can continue to take clear fluids up until 4 hours before the test (water, apple juice, Gatorade, jello, soup broth, popsicles).
          • On the day of your test, approximately 30 minutes before leaving home, use the two enemas. Read the instructions on the box. It is best to give them in the bathroom, lying on your left side, on the floor if you have room. You may lubricate the tip of the enema with Vaseline or lubricant jelly.
          • Insert the tip carefully, into the anal canal and empty the whole contents of the enema, by squeezing the bottle into the rectum.
          • Hold the enema in as long as possible (usually 5 to 10 minutes), then defecate the contents into the toilet.
          • Repeat steps 3 and 4 with the second enema.
          What happens during a Sigmoidoscopy?
          • Small tissue samples (biopsies) may be taken during the test.
          • Air is inserted during the test which you will need to pass out later.
          • The enemas taken prior to the procedure help ensure that your rectum is free of stool, letting the doctor see as much as possible at the examination.
          • Depending on your preference, you may receive medications (sedation) through an intravenous catheter just before starting the test to keep you comfortable. If you receive sedation, you will not be able to drive or go back to work after your test, and you will need to arrange a ride or take a taxi with someone accompanying you.
          What happens after a Sigmoidoscopy?
          • After your procedure, you will rest in the recovery area for about 30 minutes. You may feel some bloating after the procedure because of air that was introduced during the examination. Please allow about 2 hours for your entire appointment.
          • While these procedures are associated with very low risk when performed by physicians specially trained in this discipline, they may still occur:
            • Drug reaction: this is rare and usually mild. This may present as rash, hives, or itching at the site of the intravenous.
            • Perforation: puncture of the bowel wall is very rare. If it occurs, surgery may be required to repair the perforation.
            • Bleeding: a small risk of significant bleeding may occur after polyp removal. This can occur up to 7 days later. This usually stops without treatment. Rarely, blood transfusions or surgery is required.
            • Sedation: may cause respiratory depression or lowering of blood pressure.

          Preparation Sheet

          Endoscopy Information Sheet – English

          Endoscopy Information Sheet – Chinese

          Referral Forms

          Patient Referral Form

          Fibroscan Referral Form

          Learn More About GI

          Center Care Ontario

          • “Every year, over 9,000 Ontarians (slightly more men than women) will be diagnosed with colorectal cancer, and over 3,000 Ontarians will die from it.”  (Cancer Care Ontario)
          • Colon cancer is preventable.  Get screened.  Screening guidelines from Cancer Care Ontario.

          Low FODMAP Diet

          • The low FODMAP diet was developed by researchers at Monash University. There is evidence that a low FODMAP diet improves irritable bowel syndrome symptoms.
          • FODMAPs (Fermentable Oligo-Di-Monosaccharides and Polyols) are
            carbohydrates (sugars) found in foods.

          These include:

          • Fructans (fruits, honey, high fructose corn syrup)
          • Lactose (dairy)
          • Fructans (wheat, garlic, onion, etc)
          • Galactans (beans, lentils, legumes including soy, etc)
          • Polyols (sweeteners with sorbitol, xylitol, mannitol; stone fruits such as avocados, apricots, cherries, peaches, plums, etc).
          • Symptoms of gas, bloating, distension, flatulence, cramping and/or diarrhea may occur in those who are sensitive to the effects of FODMAPs.

          Canadian Digestive Health Foundation

          This includes a digital library with videos and webseminars.

          Printable resources for common gastrointestinal conditions from Gastrointestinal Society – Canadian Society of Intestinal Research

          Dietitians of Canada

          You can search for a dietitian in your area.

          Probiotics Chart.  This is a clinical guide based on systematic reviews on current evidence for various probiotics and their level of evidence based on indications for us.

          Crohn’s and Colitis Canada

          The only national, volunteer-based charity focused on finding cures for Crohn’s disease and ulcerative colitis.  Patient education brochures are available to help patients understand dietary, medications, surgical and cancer implications of inflammatory bowel disease.

          Canadian Celiac Association

          This is a great resource for patients with celiac disease.

          About Dr. Justina Sam

          Dr. Justina Sam is a general gastroenterologist. She sees patients with gastrointestinal issues and performs gastroscopies and colonoscopies. She graduated Summa Cum Laude from the Bachelor of Health Sciences (Honours) Program at McMaster University.

          Dr. Sam completed medical school and training in internal medicine and gastroenterology at The University of Toronto. She was the co-chief resident during her gastroenterology training and was the recipient of the Dr. KN Jeejeebhoy Award for Excellence in Gastroenterology.

          She is a member of the Ontario Association of Gastroenterology and the Canadian Association of Gastroenterology.

          She worked for 2 years as a gastroenterology clinical associate at North York General Hospital doing primarily inpatient work and caring for patients hospitalized with acute gastrointestinal issues, where she managed patients in the emergency room, on the wards, and in the intensive care unit. She also worked for 6 months covering an established gastroenterologist’s practice at St. Michael’s Hospital, where she gained valuable experience managing patients with various conditions, particularly inflammatory bowel disease and irritable bowel syndrome. Dr. Sam decided to settle down in an outpatient gastroenterology practice.

          She speaks Cantonese and English and some Mandarin. There is Mandarin translation available through our office.

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