The Digestive System

The teaching unit comes under the Digestive System and Liver Department which combines Digestive System, Endoscopy and Hepatology departments, although we also work in collaboration with Internal medicine, Intensive care medicine, Emergencies and Radiodiagnosis, Nutritional support and Digestive Surgery Departments. 

In daily practice, resident doctors visit the patients along with their staff doctors, preparing the clinical record and making the physical examination under their supervision. They also make an assessment of the supplementary tests such as endoscopic, radiology, manometric, and anatomy and pathology examinations needed for proper decision making and to diagnose disorders of the oesophagus, stomach, intestine, colon, pancreas, liver and bile ducts. During residency, doctors get to know about the most frequent conditions in the speciality, and often have the opportunity to come across more complex cases, which are a model for interaction with other units at the hospital. In Hepatology they have the opportunity to learn about the features of severe or chronic hepatitis, or hepatic cirrhosis, as well as carrying out the diagnosis, serological tests, treatment and the possible complications, if there are any, and prevention. During their turn in Endoscopy they have gradual, supervised training that covers all from diagnostic examinations to basic therapeutic endoscopy, as well as assisting those responsible for advanced endoscopy techniques, such as endoscopic ultrasound and endoscopic retrograde colangiopancreatography.

Residents in the Digestive Department are on call for internal medicine during the first year and, subsequently, from the second year of residency onwards, are specialist on-call doctors (approximately 4 shifts per month), alongside a physically present department member.

The Digestive System Programme also carries out significant scientific work at the Vall d’Hebron Research Institute and CIBERehd, with five lines of research:

• Gastrointestinal motility: clinical research into the digestive system’s sensory-motor function and its relation to diet, and abdominal and microbiota content.
• Inflammatory bowel disease: basic, translational and clinical research into inflammatory bowel diseases on subjects such as: interaction of intestinal microbiota with the intestinal mucous membrane; validation of biomarkers relating to clinical remission and response to treatment; the effect on intestinal microbiota of interventions with probiotics and prebiotics; validation of pharmacokinetic models; research into vaccine response or quality of life and patient satisfaction.
• Intestinal microbiota: the aim of this line of research is to understand the role of intestinal microbiota in digestive disorders using “omics” techniques.
• Pancreas and bile duct disorders: development of new experimental models to study the genes regulating the appearance of chronic pancreatitis and pancreatic tumours.
• Neuroinmunogastroenterology: basic, translational and clinical research into disorders related to brain-intestinal axis dysfunction, such as irritable bowel syndrome and functional dyspepsia and chronic inflammatory illnesses such as microscopic colitis, coeliac disease, eosinophilic oesophagitis or diarrhoea caused by bile acids.

We offer you a teaching programme designed following the National Council for Digestive System Speciality’s programme. Internationally the department is recognised as a European Training Centre by the European Community's European Gastroenterology Board and as a receiving centre for the UEG Clinical and Research Visiting Fellowship programme and as a collaborator in the Rome Foundation Research Institute’s Investigator Network. Treatment-wise we have membership in national units of reference, such as the Neuroendocrine Tumours Committee and the Adult Primary Immunodeficiency Committee. Furthermore, from the research point of view, our unit has been recognised as a group of excellence by AGAUR (University and Research Grant Management Agency) since 2009 and as a CIBERehd (Centre for Network Biomedical Research on Hepatic and Digestive Disorders) group since 2008.

 Why practise this speciality at Vall d'Hebron?

• Because we have around 1,000 admissions to the hospital wards each year, which enables the acquisition of very broad clinical and care experience.
• Because we have a Semi-critical unit with 4 continuous 24 hour care beds where we look after patients with serious digestive disorders (digestive haemorrhage, acute pancreatitis, serious complications from cirrhosis and acute cholangitis) where a multi-disciplinary team works assembled from Hepatology, General surgery, Endoscopy, Radiology and Surgical vascular radiology.
• Because we are a part of the Specialist Outpatients Network (RAE/CAE): 3 specialist outpatient clinics making an average of 10,000 visits to the community annually.
• Because when on-call, the resident is supervised by the associate doctor on-call in the Semi-critical Unit during the three final years of residency, to ensure effective, safe learning.
• Because we have an accredited Crohn-Colitis Care unit where, apart from conventional medical care, patients are monitored biologically, psychologically and socially. We currently monitor a total of 2,800 patients, which means we can carry out clinical and basic research in the experimental laboratory.
• Because the Gastrointestinal Motor Disease Unit is a national and international benchmark for the study of patients with serious motor and functional disorders.
• Because we have the Pancreas unit, specialising in dealing with complex illnesses such as cystic fibrosis, serious pancreatitis, chronic pancreatitis, pancreatic tumours and bile conditions, which are addressed by various committees in a multi-disciplinary manner.
• Because in the Hepatology Unit you have the most modern diagnostic procedures at your disposal and you will be able to participate in the treatment of portal hypertension-related complications, liver transplants and the use of the pioneering drugs.
• Because the Digestive Endoscopy Unit has the capacity to carry out 15,000 diagnostic and therapeutic examinations annually.
• Because we have state-of-the-art technology and equipment for diagnostic and therapeutic endoscopy, including the most recent advances in surgery by mouth (POEM), enabling gastroscopy, duodenoscopy, colonoscopy, colangiopancreatography and endoscopy to be performed.
• Because we offer you, and, during residency, encourage you to collaborate in, research lines in the department, to learn scientific method, to read and write articles in a critical way, to take part in research studies and present the results at conferences and in publications to complement you training and CV, and to increase your competitiveness after the residency.
• Because at the end of the residency we support your incorporation into one of the research lines and your application for pre-doctorate grants to be able to do your doctoral thesis.
• Because the Digestive System Unit at Vall d'Hebron is in contact with the majority of the national and international scientific societies of reference, which makes internships abroad easier at the end of the residency.