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THE LIVER HEALTH CLINIC

Our practice

Dr Supriya Joshi is a specialist in Liver Disease and Gastroenterology.

She completed her undergraduate and medical degrees at Western University in London, Ontario before attending The University of Toronto to complete post graduate medical training in Internal Medicine and Fellowships in both Gastroenterology and Hepatology. She is currently completing coursework in Obesity Medicine.

Since 2004, she has been practicing both Gastroenterology & Hepatology at Credit Valley Hospital, Trillium Health Partners in Mississauga, Ontario. She held an Associate Staff position at Toronto Western Hospital from 2004-2007 supervising clinics specializing in autoimmune liver disease. She continues to be a Lecturer at The University of Toronto and is involved in the education of medical trainees and residents.

She has published in the areas of Hepatitis C, Hepatitis B, NASH as well as autoimmune liver disease. In recent years, she has developed an interest in metabolic health and has been invited to speak within her expertise on these topics to both medical and non medical audiences.

She performs her endoscopic examinations (gastroscopy & colonoscopy) at Credit Valley Hospital and at WGTA Endoscopy.

Other commitments:

HepCure: Medical Advisor of organization aimed at finding and treating people with Hepatitis C infection.

Fatty Liver Alliance: Chair of the Medical Advisory Committee. Organization aimed at patient advocacy, education and research

Our mission

Optimizing the health of your liver, preventing disease progression and managing its complications is our specialty.

Chronic liver diseases can lead to liver injury which can result in fibrosis (scarring) and possibly cirrhosis.

Degree of injury can be determined from assessment of lab tests, Fibroscan (noninvasive) or sometimes, a liver biopsy.

A very scarred, fibrotic liver (cirrhosis) can lead to poor liver function and increase the risk of liver failure and liver cancer, both of which can affect quality of life and life span.

It is important to discover the cause behind the liver inflammation so that further progression can be prevented by initiating the correct treatment strategy.

Every referral is reviewed and triaged.

Lab tests, further imaging or Fibroscan (read below for more details) may be arranged with you prior to consultation to efficiently assist in your care.

Our location

Our practice is conveniently located in the medical building within the parking lot of The Credit Valley Hospital in Mississauga. Our office is in the 2300 building across from the hospital on the corner of Erin Mills Parkway and Eglinton Ave west.

It is easy to get to by car (near highways 401, 403 and QEW) or public transportation.

Telemedicine and virtual care available.

Suite 509, 2300 Eglinton Avenue West

Mississauga, Ontario

L5M 2V8

Common Liver Conditions requiring our expertise

Abnormal Liver Enzymes

Abnormal liver enzymes can result from single, or sometimes multiple causes. Assessment to investigate the cause includes a detailed medical history, blood tests which will be performed at your local laboratory, an ultrasound of your liver, as well as a FibroScan. FibroScan is a noninvasive (no needle) method of assessing for liver injury and liver fat content. It is performed within a few minutes, does not cause any discomfort and provides different information from an ultrasound. FibroScan is a non-insured test (not covered by OHIP but covered by many private insurance plans) which is payable to the vendor. Further info: https://www.liverscan.ca/services

A liver biopsy is another test that may be necessary to evaluate the health of the liver.

There are many conditions that can cause liver enzymes to be elevated, including:

chronic alcohol intake
non alcoholic fatty liver disease (NAFLD)
medication and drug induced injury
viral hepatitis (Hepatitis B and C)
autoimmune liver disease
genetic and inherited diseases
malignancy

Once the diagnosis is made, the correct treatment is initiated which may include lifestyle counselling, medications, antiviral therapy, medications to suppress the immune system or referrals to other specialists.

Non alcoholic Fatty Liver Disease (NAFLD)

Fatty Liver is the most common cause for liver enzyme elevation and affects at least 25% to 30% of the population. NAFLD can progress and may cause various degrees of liver inflammation and subsequent fibrosis (scarring) and eventually cirrhosis.

It is becoming the leading cause for liver transplant in North America.
It is reversible if found and treated early.
It is highly associated with elevated body weight, Type 2 Diabetes and Metabolic Syndrome

To investigate this we will assess where you are on the spectrum of liver injury (fibrosis) by arranging blood tests and a non-invasive method to assess liver fibrosis (Fibroscan).

Treatment provided includes dietary and lifestyle counselling and modifications, correction of nutritional deficiencies and potential treatment with medications.

For more information, visit https://nashnet.ca and https://fattyliver.ca

Identification of abnormalities seen "within" the liver

Small growths (lesions) are commonly seen in the liver when Ultrasounds or CT scans are performed for various reasons.

It is important to distinguish between benign (non-cancerous) lesions from those that may require more testing or possibly even surgical removal. The majority of liver lesions are benign and do not require any further testing.

liver hemangioma
focal nodular hyperplasia (FNH)
hepatic cysts
hepatic adenomas
malignancy - primary liver cancer (hepatocellular carcinoma) vs metastasis

To further assess a liver growth, blood tests, a specialized CT scan or MRI may be arranged and possible referral to Hepatobiliary Surgery or Liver Transplant Assessment.