Archived Responses: 

2008 - 2009 Reviews

Pediatric Gastroenterologist for 2 year old

June 2011

My 2 year old son has been diagnosed with Delayed Gastric Emptying, reflux, and multiple food allergies. We are currently working with a GI doctor who has been somewhat helpful, but my son continues to be in serious pain, and the doctor isn't sure what else to do for him. As his mom, that's just not good enough for me....I need to find someone who can figure out why he is still in a significant amount of pain.

Have you taken your child to a GI specialist that you love? Right now we're working with a GI specialist at a Children's Hospital, but we're open to any hospital team, or a private practice GI. Alternatively, any GI docs that we should avoid?

We live on the Peninsula, but we're open to driving anywhere to see someone great. Please feel free to ask moderator for my email if you'd rather discuss this privately.... Thanks so much! Concerned Mom

We really, really, like Fadi G. Haddad, M.D. who is in private practice in Walnut Creek (925-975-0775, He is extremely thorough and correctly diagnosed our daughter with a serious condition after it was missed by a highly recommended pediatric GI at Children's Hospital Oakland. Good for you for following your instincts and seeking another opinion in case something has been missed or there are other, better, treatments available. Good luck. Whitney
We have been very happy with Dr. Fadi Haddad. He is extremeley thorough and has a great way with children. His office is in Walnut Creek, near John Muir Medical Center. I'm not as fond of his partner though so stick with Haddad. Celiac Momma
i sent a request to the moderator for your email, but haven't heard back yet, so feel free to contact me directly at the email below. depending on the diagnosis, IMO there are a few good pediatric gi's in the area. however, my daughter was diagnosed w/ an autoimmune disease approx 9 months ago that presents much as how you've described your son and is related to food/environmental allergies and intolerances. it's called eosinophilic esophagitis, or EoE, (she also has eosinophilic colitis) and can only be diagnosed through scope (endoscopy/colonoscopy) AND tissue biopsy. for this disease, the dr must also be familiar w/ the protocol for where to biopsy. dr. cox at stanford has been recommended to us, but we currently see dr melvin heyman at ucsf. both are pediatric gi's, and both come highly recommended. however, for my daughter's diagnosis, i'm still figuring out if any dr in the bay area has enough experience treating this complicated disease. i have too much info to put in a post, so please email me if you'd like to talk further. best of luck, there's not much worse than seeing your child in such pain. emily
I am sorry that I didn't see your original post, but one of my children saw Mel Heyman at UCSF for reflux and didn't get much relief or help from conventional medicine. One of her friends also saw Dr. Heyman, had very extensive tests, and then the diagnosis turned out to be lactose intolerance, which maybe should have been considered before innumerable and invasive tests.

In the interim, two adult GI docs recommended a Dr. Haddad in Walnut Creek to us, both saying that they thought highly of him. We never saw Dr. Haddad because I submitted to having my child treated with acupuncture and herbs, and she is about 80-90% better. Go figure. Good luck to you. GI stuff can be tricky. Anon

Hi: My son suffered years of frequent stomachaches, loss of appetite, and malabsorption. He had no weight gain for a couple of years and was in 1 percentile for ht and wt. It was worrisome. Saw Dorsey Bass, at PAMF, then Mel Heyman at UCSF. Dr. Bass could find nothing wrong. Dr. Heyman ran extensive tests and surgery to scope out the problems. All very expensive but none of which provided any real answers whatsoever. Fortunately, we found an excellent Chinese acupuncturist and in 3 months, acupuncture has made a huge difference at a fraction of the costs. Anonymous

2008 - 2009 Reviews

Pediatric Gastroenterologist for my 3 yr old

Dec 2009

I am looking for a referral to a good, experienced Pediatric Gastroenterologist for my 3 yr old. I am looking for someone who is willing to perform procedures themselves vs. Fellows as is the practice at the teaching hospitals such as UCSF or Stanford. Thanks in advance.

Elizabeth Gleghorn at Children's Hospital Oakland has been incredible. She is very responsive (we get emails responses at 10 at night!) and is head of the GI dept at CHO. Our kid is sort of complicated (in heart failure and has a feeding tube, etc) and she's been great to work with. She's kind of no-nonsense but has a great sense of humor if you can break through :-) Good luck! Jaime
My 4-year-old is a patient of pediatric gastroenterologist Fadi G. Haddad, M.D. in Walnut Creek, 925-975-0775, He is extremely kind and thorough and has done a wonderful job diagnosing and treating my daughter. We got to him after having a bad experience somewhere else. Dr. Haddad has performed several procedures on my daughter and yes, he does the procedures himself. I highly recommend Dr. Haddad. He is well worth the drive through the tunnel. Whitney
We have had great success with Dr. Fadi Haddad in Walnut Creek. (925-975-0775). He does his own procedures and is affiliated with John Muir hospital. Ellie
Two words: Children's Hospital.
-- Pediatric RN

Pediatric Gastroenterologist at Children's Hospital

May 2009

My daughter was recently referred by her pediatrician to the Children's Hospital GI department to rule out mal-absorption issues as she is just 17lbs at 17 months old. We have an appointment in late June with Dr Elizabeth Gleghorn. I'm interested in hearing about experiences with this MD. I am hoping that she will listen, is not too invasive with care and will take into account family history (both my husband and I were small babies, and I have GI issues). Thanks in advance for sharing your experiences. Angela

Hi, I am a therapist at Children's and work with many of her patients. I wanted to assure you that you are in very good hands with Dr Cleghorn and with CHO in general.
I have read positive reviews of Dr. Gleghorn on BPN. So there definitely are people who were happy with the help they received. My experience with Dr. Gleghorn is unfortunately not positive. I found her rather dismissive. I got the feeling if your child doesn't have a condition that she deems to be severe enough, she will not treat your child as a patient really needing any help. When talking to my child's other doctors at CHO, about the outcome of the visits, I heard that this was not unusual for her. Now, this could still just have been an isolated, unfortunate occurrence. However, other parents I have met over the past years, who needed a pediatric GI for their children, confirmed having had similar experience with Dr. Gleghorn. I have to say that all the children I am talking about, were born with systemic anomalies, and were clearly not simple cases that didn't need intervention. I have also expressed my concerns to other, new parents with issues similar to your child's. They also heard similar opinions from their own doctors about Dr. G. You may still go and see for yourself. If you don't feel you got the help you expected, I suggest you try to get referred to UCSF for a second opinion. Good luck.
pretty sure she's the doc we saw when my daughter had some apparent reflux issues. She was great-straightforward, reassuring, not at all invasive (recommended against a more invasive procedure that would have possibly given us more definitive info, in favor of the ''most likely solution'' w/ basically no adverse side effects.) She's smart, didn't mind lots of questions & challenges on my part. So don't worry.
I have worked with Dr. Gleghorn for 12 years and she is as dedicated a doctor as there is. At Children's Hospital Oakland we are all very dedicated and spend long hours there, but Dr. Gleghorn is surpassed only by a handful of doctors for the time she puts in at the hospital. She is an expert in Pediatric GI, unsurpassed by anyone else I have worked with in my career and I've had the finest training at the top medical centers in the country. Dr. Gleghorn is the one to see to make sure you are getting the best possible medical Pediatric GI opinion. Pediatric Specialist
Dr. Gleghorn was my son's Gastroenterologist (sp?) approximately 10 years ago. At one years of age he developed aspiration and needed a GT tube. I wouldn't say she has a cuddly bedside manner but she was a good fit for our family. I found her and her staff accomodating, knowledgeable and helpful through our four year ordeal. Of course this was 10-14 years ago but I imagine she has even more experience then she had at that time. Sharlene

Pediatric Gastroenterologist for 2 year old with stomach pain

April 2009

I have a 2 year old with stomach pain (gas pain or ????) throughout the night causing her to wake up hourly. She has a history of stomach problems from when she was 6 months old. Frequent vomiting, gas, pain, etc. She has had an upper GI and they found nothing abnormal. She does not have pain when she eats or drinks and reflux is not suspected. We can go to any area -even Sacramento area. Thank you! yvette

Dr. Fadi Haddad in Walnut Creek has helped my daughter with the sames kind of problems. He's very nice and genuinely concerned. Here's his info: Good luck! Mom whose been through a few pediatric GI docs

Gastroenterologist for Crohn's Disease

Feb 2009

Hello BPN family, I recently changed medical groups and I've been given a list of gastroenterology doctors, but I'm having a hard time learning anything about their bedside manner, etc. I am pregnant, and although my Crohn's is stable, I need to renew my prescriptions and get some blood work done in the next few weeks. Thank you

Paul Chard is EXCELLENT. He has a terrific bedside manner -- he is very thorough, patient, listens very carefully, follows up, and has a good sense of humor. I recommend him very highly! mary
My GP sent me to Villagomez for my colonoscopy, and I was happy with her (as happy as anyone could be given the procedure!). Her office is well run, and she is personable and competent. Linda
When I turned 50 and opted to have an colonoscopy, my MD referred me to Dr. Thomas Hargrave. When I met with him he was personable and smart and he inspired confidence. Should I need a GI MD in the future I would seek his services. Mimi, Berkeley
Both my husband and I go to Dr. John Roark for our preventive screenings (colonscopy and endoscopy) and have the utmost respect for his abilities. My husband has GURD and is also happy with his treatment. anon
I used to see Silvia Villagomez (had to change because of insurance) and loved her. She diagnosed my Crohn's shortly before I became pregnant with my first child and did a great job both during and after pregnancy, when I had a flareup. I was really sad to leave her. I also really like Paul Chard on a personal basis, but don't know him at all professionally. My impression, though, is that he would be great. Been there with Crohn's
Dr. Hargrave is my GI doctor and I like his chairside manner very much - he seems genuinely concerned when we meet in his office. He's one of those obviously brilliant people whose mind works at lightning speed, so I sometimes have to ask him to slow down, which he does. He's got a wonderfully dry sense of humor, which I appreciate. He did my colonoscopy and I didn't feel a thing. I know one of his partners, Mike Darby, because I am an RN and worked with Mike years ago when he was a resident. I found him warm, empathic and also extremely smart. John Roarke was my GI doctor for a brief period about 15 yrs ago -- brief because I found him rude and arrogant, and not a good listener. He never apologized for the long waits and took phone calls during my appointment. I would definitely not recommend him. anonymous
I saw Liana Vesga recently for what she ended up diagnosing as IBS. She has a good bedside manner, and did not push any tests or drugs on me, which I liked. Overall, I had a good experience with her, though this is based on one visit only. anon

pediatric gastroenterologist in the East Bay Area

Jan 2009

I will be very grateful to get a referral for pediatric gastroenterologist in the East Bay Area. julia

I work at Children's Hospital in Oakland, and can recommend the GI physicians there, Drs. Gleghorn, Harmatz and Ali. I can also recommend Dr. Haddad; I believe his private practice is in Walnut Creek. They are all experienced and excell at what they do. Children's Hospital RN

Gastroenterology Associates of the East Bay

Oct 2008

Has anyone had experience with any of the doctors at Gastroenterology Associates of the East Bay (Berjis, Bhuket, Chalal, Cheng, Higa, Hosseini, Narayan, Silpa)? My doctor there retired and I know nothing about the other doctors. Thanks! Looking for a good doctor

Regarding GI docs, the one you mentioned that I am familiar with is Dr. Bergis. I am a dietitian working in home health in E. Bay for 5 yrs and have consulted with Dr. Bergis a few times regarding patients. He has great bedside manners and is responsive in a timely fashion to calls. I get the feeling he is well informed of newest research as well. Best of luck. RD from visiting nurses assn.
I had a colonoscopy performed by Dr. Hosseini about 4 years ago that went perfectly. Good luck. Anon
Well I saw Silpa a few times for a procedure. He was friendly and very to the point when talking. That was two decades ago, however, so I don't know what he is like now. Anon
May 2008

I'm scheduled for a colonoscopy in a few weeks with Dr. Michael Abel. He's in SF, but I think it's worth the short trip from the east bay to go to a really good doctor. He was highly recommended to me by my father's doctor. (My dad has colon cancer and is being seen by a team of top doctors in NY.) I can't yet comment on the procedure, but my office visit with him went very well and I am confident in his abilities. I was happy to learn that he uses the ''pill'' prep rather than the ''liquid'' I've heard is so unpleasant. I don't know if many doctors would allow you to deviate from the standard prep that they use. My understanding is they are pretty strict about that.

I don't know if she's ''excellent'', but I have had many colonoscopies performed by Dr. Silvia Villa Gomez. She's with a large practice in Oakland at 3300 Webster Street, Suite 312, 444-6421. She has served me well, including referring me to a surgeon for a polyp she couldn't remove during the colonoscopy that turned out to be stage 2 colon cancer. She is very gentle, very personable, and sweet. On the prep, just do whatever your doctor recommends. You need to be cleaned out completely. Just grin and bear it. It's just 1/2 day of discomfort. The prep has evolved, and most no longer involve drinking a gallon of medicated fluid. Anything is better than that. Veteran of Many Colonoscopies
You don't think recommendations from February 2007 are recent enough? That's barely a year ago. Maybe you didn't see that part of the site?

Mine is the first recommendation for Dr. Villagomez. anon

2006 - 2007 Reviews

gastroenterologist for irritable bowel syndrome

Oct 2007

My husband has been having ongoing stomach problems, diagnosed as irritable bowel syndrome. Has anyone had a good experience lately with a gastroenterologist? We'd appreciate any recommendations offered. We're considering alternative routes, too. Is anyone familiar with a good naturopath? Thanks for your suggestions. Concerned Wife

I have had 2 colonoscopys with Neil Stollman in Oakland. He is smart, down to earth, funny, and his staff is great. I went in with a problem that had beem misdiagnosed for 18 months. He listened, tried some probiotics and when they didn't work said ''let's see what's going on in there''. It turned out to be a serious upper colon infection that would not have gone away on it's own. I was on meds for 7 months and now it's gone. I always prefer 'alternative' practices but even my accupunturist said I needed to do this. Don't mess with the GI tract. a wuss who's been there
I recently saw Liana Vesga at the East Bay Center for Digestive Health, also for IBS (she diagnosed it). She seemed knowledgable, I thought she had a great manner, listened carefully, and didn't seem to push any unnecessary intervention or medication. I only saw her once, but this one interaction was very positive. anonymous

Need a Surgeon for ''The Wrap'' (GERD)

June 2007

Has anyone had a positive (or negative) experience with a 'Laparoscopic Nissen Fundoplication' aka ''the wrap''? After the birth of my 3rd child I learned that I have several reflux and a medium sized hiatal hernia. I would like to get this repaired so that I don't feel sick all the time (I have constant regurgitation - it's like morning sickness all the time!) and also don't have to take medicine for the rest of my life. (I've made all the ''lifestyle'' changes recommended, but unfortunately none of them have made a dent in the symptoms.) I've heard mixed things about the success of this procedure and don't know how to find out the reputations of the surgeons who perform the procedure. Has anyone had this experience? Know of any surgeons who do the procedure? Thank you so much! Hoping to feel better

I too suffered from severe acid reflux for years -- my whole life probably -- until I just couldn't live with it anymore. I had the nissen fundoplication surgery four years ago and couldn't be happier with the results. Before the surgery, my diet was incredibly restricted and I took prilosec-like meds at the highest doses every day and STILL had constant pain. Now I eat whatever I want pretty much, although I still go easy on the very acidic stuff. Occasionally I get heartburn and take an antacid -- just like a normal person!

I had the surgery in SF (where I lived at the time) at California Pacific, the Pacific Campus. My grastroenterologist was Dr. Frank Farrell on Geary. He was great -- really nice and smart. My surgeon was Dr. Lawrence Yee. He's not the touchy-feely type, but he's competent and thorough and, well, he fixed me!

The downside to the surgery is that it is, well, abdominal surgery. Even though it's laparoscopic, I found the recovery to be tougher than I expected. I took two weeks off from work, and I should have taken 3 or 4. Eating and swallowing were challenging for quite some time post-op and I lost 15 pounds or so (not a bad thing I guess). My advice is just to make sure you take enough time to heal and recover.

Also, the testing that I had to do prior to the surgery was pretty brutal. I had to wear a pH monitor for 24 hours (tube down my nose into my stomach) and had to do a couple of yucky x-ray type tests too.

But again, I am fixed. Seriously, it was worth it. If I have to have it re-done in the future I will be disappointed, but I will still do it. no more tummy troubles

Gastroenterologist near Walnut Creek

Oct 2006

I am looking for a gastroenterologist in the Walnut Creek area. I am looking for someone who is clinicially competent but will take the time to get a complete picture of my medical situation. Anyone have any recommendations? anon

I just had a very good experience with a Dr. Shehendu Narayan (not sure if I'm spelling the name right) who performed a screening colonoscopy. He has an office in Walnut Creek and did the procedure at John Muir. I was dreading it (put it off for 2 years) and found the whole experience (including my interactions with him) to be better than I had expected. hope that helps

Doctor for G.I. discomfort and bloating

Oct 2006

I have been struggling with G.I. discomfort and bloating for the past year plus and have not been able to get any help through my regular physician and a G.I. specialist. It seems to have something to do with digestion, where through the coarse of the day my stomach gets more and more bloated.By evening it is very distended, hard, and uncomfortable with a lot of gas. I'm not sure if I should see an allergist/accupuncturist/or dietician at this point. If anyone has any experience with this and has had success with treatment please let me know what has worked and who it was that was able to help you. Thanks so much Bloated

To rule out any growths that are obstructing, you may want to get an MRI or something similar ...pelvic ultrasound?(but I'm no medical specilaist or generalist). See if you can get your doc to refer you. Anon
Never written or recommended anything on BPN, but read about your problem and had to follow up. Do you think you may have Celiac Disease? I had never heard of it before, but was just diagnosed 2 months ago, and one of my main symptoms was bloating and discomfort every evening, on top of constant diahrrea! My primary physician could not figure out my problem. Turned in endless stoll samples and did number of blood tests. Finally, a blood test was leaning toward Celiac Disease. He refered me to his friend Dr. Michael Silpa (Amazing GI specialist- 510-548-6555)who met with me and did biopsy of small intestines, which indeed confirmed that I was a Celiac. I am feeling 100% better now! Go online and research Celiac Disease, ask your dr. if he has tested you for Celiac, try going on a gluten-free diet for a couple of days, and/or give Dr. Silpa a call. Love him, but can take awhile to get scheduled for an appointment, that is unless your primary dr. is his buddy. Good luck! Celiac with happy tummy

Gastroenterologist for stomach/bowel related issues

March 2006

Does anyone know of a gastroenterologist in the Bay Area that they trust and who has a good beside manner? A friend has been suffering from stomach/bowel related issues that have affected his life for 10 years now. He has had negative experiences, thus far (primary care doc, gastroenterologist, naturopath, chiropracter) and would love a recommendation from a trusted source. He was thinking of trying UCSF, but would prefer any insight. Thank you. jen

I'd recommend Dan Conlin at CPMC. He treated my husband following some issues caused by powerful medication required to treat viral illness. It was a bit of an emergency so Dr. Conlin came to his office an hour early to meet with us, had the tests run in short order and was as soothing as could be. SF mom/wife

2004 - 2005 Reviews

Gastroenterologist for Celiacs

Sept 2004

I have recently been diagnosed with Celiacs and have been given a recommendation for both Doctor T.Hargrave and Doctor S. Villa- Gomez. Has anyone seen either of these doctors? Also any recommendations for a celiacs nutritionist would be appreciated.

Dr. Hargrave is an extraordinary and devoted gastoenterologist . He actually lectures on the topic of Celiac disease and gluten enteropathy to other doctors . I too have Celiac disease and have been seeing him since 1998. He is thorough and cares about the 'whole' patient and sets the same high standard for his staff. Elysse
I highly recommend Dr. Hargrave. He is very well respected among his peers (is on top of the latest research), is an excellent listener, and does not rush you. He has a very calming manner.

I was very disappointed when I had to leave him because he was not in the network of my company's new health plan. You will get excellent attention and care from him. Diane

I went to Dr. Silvia Villa-Gomez for some severe GI distress and she performed a colonoscopy on me. Although the consultation was very brief and felt hurried, I was able to get my questions answered.

I was referred to Dr. Villa-Gomez for her ''gentle'' demeanor by my general practitioner. Silvia does have an engaging manner and I did appreciate that (given the procedure I had to undergo). I didn't really see her for followup though -- colonoscopy day consisted of a brief wave of her hand. I'd go to see her again and recommend her. Anonymous

2003 & Earlier Reviews

Dec 2003

Re: Anal Fissure
You can't find a better doctor on this malady (and anything related) than Dr. Michael Verhille, a gastroenterologist in San Francisco (415-387-8800). He is fantastic. I also know that frequent, long, warm baths work wonders at promoting relaxation and thus healing of the area. Good luck.

Aug 2003

I have to have a colonoscopy because of a family history of colon cancer, and I'm looking for a skilled, responsible gastroenterologist who is a member of Hill Physicians. The archives only mention one doctor. Thanks! anon

Dr. Danny Wu is a very good gastroenterologist. I had a partial colonoscopy done by him and I was dreading it because I had heard how unpleasant they are. When he said he was done, I was astounded because it had been so gentle and not terrible at all. My mother needed to have a colonoscopy and she was really resisting her doctor on it. I told her about Dr. Wu; she went and she agreed with me about his technique. Good luck.
Aug 2003

My husband is looking for a gastro-enterologist, preferably in Alta Bates Medical Group, though not required. Can anyone suggest a good one? He is having issues related to liver function and wants to find someone new to get a second opinion. Anon

I really like Dr. Lisa Higa, a GI doc at Alta Bates. I have worked with her many times during my 9 years as an RN at Alta Bates. She is wonderfully friendly, energetic and very smart. I wouldn't hesitate to see her or send my family to her. Good luck. Alta Bates RN
Try Dr. Rorke (sp?) at Berkeley Digestive Health, (510) 848- 2100. I thought he was great. Very knowledgable, and is a parent of two girls- we talked about child-rearing! I first saw Dr. Naryan, who was okay, but not as personable and interactive as Dr. Rorke. Also, when I needed a return visit to Dr. Narayan because of problems, I was given a 4-5 week wait for an appointment. With Dr. Rorke, it was within a week. anon
I guess I missed the first message, so I don't know if you need a gastroenterologist with Alta Bates, but Dr. Henry Kung in Walnut Creek is the best in the area, probably one of the best in the country. He is affiliated with John Muir, Mt Diablo, and San Ramon Medical Centers. 925-945-6070
Darby and Hargrave, M.D.s, in Oakland are both superlative, have very long waiting lists, and may or may not be taking on new patients. They are partners and listed in the Oakland directory. Both are excellent, and a lot of physicians' families use them. Good luck
January 2002

I've been going to Gastroenterology Associates of the East Bay for about 15 years to treat mild colitis. I saw Ronald Adler, who was wonderful, but is now mostly retired. His replacement I've seen once, Dr. Husseini (sp?), and he seemed fine. Good luck. Kitrena


Can anyone recommend a doctor specializing in treating Crohn's disease? This is for my 17-year old stepdaughter. Fran

The gastroenterology group (not sure of the actual name) in Berkeley has several really good doctors. The phone number is 548-6555. If your step-daughter is part of an HMO, with a primary care physician, it is also a good idea to ask the primary care doctor who he/she has a good working relationship with.
My husband needs to go get his biannual colonoscopy for ulcerative colitis soon. We are new to the area since his last exam and don't know any good GIs in the East Bay that practice at Alta Bates. He picked a Doctor Rourk out of our preferred provider directory. Does anyone have experience, good or bad with this doctor? We got the preprocedure instructions and they are quite unprofessional (sloppy and hard to understand) obviously this isn't necessarily a problem since what we want is good clinical skill but since we don't know him it gives me pause. Please post replies to the list. Thanks so much!
I just had a colonoscopy with Dr. Rourke and it was fine. It was the first one I've had, and I was anxious about it, but it went just fine. Christina
I have been going to Dr. Roark, for about 13 or 14 years. He is the best, the very best. He has treated me for both polpys, and ulcers. and I have never had any complaints. Glenda
I went to Dr. Rourk about 6 years ago for some vague GI symptoms I was having. I'd say overall my experience with him was neutral. I think in terms of medical skill my impression is that he is finecertainly careful and conservative. He did a flex sig. and a upper GI endoscopy on me with no complications/problems. I didn't find his bedside manner particularly enchanting. He couldn't get to the bottom of what was bothering me but I don't think that was his fault.
Sorry about your husband's colitis. Hopefully he has some nutritional support to relieve the irritation. A great book on this topic is called BREAKING THE VICIOUS CYCLE by Elaine Gottschall. Meanwhile, I too am having a colonoscopy by Dr. Roark. He is well-regarded and says has had no complications from this procedure in the years he has performed it. Mine is being done 2/20/01. If your husband's follows mine, I will be happy to share the experience. The office help/support has always seemed to me a bit overcommitted-- hard to get through on the phone, difficult to be acknowledged when arriving for appointments, some abruptness in conversation. And I too agree that the instructions were abit sloppily prepared, but I understand them. A small tidbit I got from the office: on the last day when only liquids are allowed, I was told that I could drink as much of Vanilla Lite Ensure as I want: it has zero fiber (and redeeming nutritional value, in my opinion) and will not interfere with the procedure's success. But I suggest he check for himself. Good luck! Nori