We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
This test is performed to check if there are alterations in the motility (movements) of the stomach and the small intestine when fasting and after eating.
The gastrointestinal manometry allows us to detect changes in the movement of the oesophagus, as well as making sure the oesophageal sphincter opens and closes properly to allow food to pass properly from mouth to stomach. It is also useful for assessing the condition of the inner oesophageal sphincter and making sure it closes properly in people who suffer from acidity, heart burn, retrosternal pain or repetitive pneumonia. It also allows us to check the results of some treatments, surgical or otherwise, that affect stomach motility.
Firstly, a thin tube is inserted through the mouth that connects to a device that records the movements, a.k.a. motility, of the small intestine. We then check the device is placed properly using an x-ray.
During the test, patients should be lying down on a bed and given a light meal that they can easily swallow.
This test lasts an average of 6 hours.
Once the test is done, the professional interprets the results in order to define or discard a diagnosis.
The process of placing the probe is uncomfortable and can cause nausea, which disappears when the probe is in the right position.
Endoscopy with endoscopic capsule is used to study the intestines. In order to perform this exploration, patients must swallow a small capsule that travels naturally through the gut. As it makes its way down, this capsule collects images that are studied later.
To do this test, sensors are placed in the abdomen of the patient along with a belt with a recorder with a battery. The patient then takes the capsule with some water. The study will last 8 hours, during which the person having the test done cannot perform any activities that involve stretching, abrupt physical exertion, bending or carry out any physical activity.
The capsule comes out with the patient’s stool, but the images it has taken are saved on the recorder that the patient is wearing on a belt.
The patient must inform the doctor of all medication he/she is taking, in order to make any necessary adjustments. Also remember to follow the instructions of the professionals relating to what solids and liquids to consume before and after the test.
During the procedure, patients cannot go near areas with strong electromagnetic fields, such as amateur radio equipment or magnetic resonance imaging.
Once the endoscopy with capsule is done, patients must check their stools to make sure the capsule has been expelled properly.
Fibrocolonoscopy, or colonoscopy is an exploration that is performed to examine the large or small intestine or, if necessary, the final part of the small intestine.
If you are a diabetic patient, check with your doctor to find out about the medication guidelines you should follow.
The duration of this test is usually no longer than 30 minutes, as long as no therapeutic treatments are performed.
The aim of the intestinal biopsy is to obtain a surface fragment of the mucus of the small intestine to analyse it under a microscope. This sample helps us to determine if the patient has any disease or health problem, as well as showing us how the patient is progressing.
To take the sample, a very thin catheter is inserted through the patient's mouth to the area being explored. Then the person undergoing the test must change position until the doctor makes sure that the capsule is properly placed using x rays.
When the position of the capsule is correct, a syringe is used to collect a sample, what we call a "biopsy".
Sometimes, it is necessary to move the catheter to make sure the capsule is properly placed, which does not hurt, but can cause irritation to the throat or a feeling of nausea.
The risks involved are minimal. There may be complications, such as perforation, bleeding or difficulty in removing the capsule, though these are very rare.
Gastroenteritis is an infection that causes diarrhoea, an increase in loose stools. It is normally accompanied by vomiting, fever and stomach ache.
Every time the child passes diarrhoea or vomits they lose fluids and they need to replace them orally (by drinking). To achieve this, electrolyte solutions can be used.
If the child is vomiting, they will need to drink the solution bit by bit (one teaspoon every 5 minutes). If they are not vomiting, increase the amount gradually.
When they are not vomiting, offer them small amounts of food. Never force them to eat and make sure they drink plenty of fluids between meals.
The child should not be fasting. Offer them food without forcing them to eat. Infants with gastroenteritis normally lose some of their appetite. If they are breastfeeding, the number of feeds should be increased. Milk bottles should continue to be given in the normal doses, they should not be diluted.
A dry diet is not necessary, soft foods can be eaten if preferred. The foods that tend to be tolerated better are cereals (rice and wheat), potatoes, bread, lean meat, vegetables, fish, yoghurt and fruit. Avoid foods that are difficult to digest, with lots of fat and sugar.
To recover lost fluids, do not use homemade solutions or commercial drinks. Solutions prepared specifically for rehydration are recommended.
Do not administer medications for vomiting or diarrhoea without consulting a paediatrician.
It is estimated that more than 5% of the population suffers from chronic diarrhoea, a condition which lasts for four or more weeks, and that close to 40% of sufferers are over the age of 60. Normal stool frequencies vary from three times a week to three times a day. Diarrhoea may be defined as reduced consistency and increased fluidity of stools, bowel movements causing abdominal cramps or discomfort or increased stool frequencies. Consistency of stools is determined according to the Bristol stool scale, a specially designed visual chart that classes stools under 7 categories, according to form and weight.
An evaluation has to be made of the presence:
The list of possible causes for chronic diarrhoea is extensive (see Table 1 of the attached document “Chronic Diarrhoea: Definition, Classification and Diagnosis”) and numerous tests often need to be carried out before a final diagnosis can be made.
The most frequent causes of chronic diarrhoea in our environment are bile acid malabsorption and functional disorders, above all irritable bowel syndrome and intolerance to carbohydrates such as lactose.
It is useful, from a clinical-practice perspective, to class patients with diarrhoea according to whether they present characteristics that suggest “functionality” – a diarrhoea that appears without an organic cause justifying it – or “organicity". This distinction is important, as the two situations’ diagnostic approach and treatment obviously differ.
Where an organic disease is suspected, preferential action often has to be taken, in contrast to a suspected functional disorder, which may defer the diagnostic procedure somewhat.
Symptoms and alarm signs where potentially serious organic diseases causing chronic diarrhoea need to be ruled out first are:
There are currently no specific recommendations for preventing the appearance of this disease. We recommend:
Acute hepatitis consists of an acute inflammation of the liver that makes the liver not work properly. This is normally brought on by a virus, pharmaceuticals or other toxins.
The symptoms are very varied and often go unnoticed. The most common are fatigue, poor appetite, nausea, muscle pain and fever. Occasionally, a yellow tinge appears in the whites of the eyes and the skin (jaundice), and urine becomes dark in colour (choluria). Symptoms may persist for one to three months before recovery. Hepatitis B and C may become chronic.
Hepatitis A affects children and young people. Thanks to improvements in health and hygiene in our country, the disease now quite rare. It may be found in patients who have recently visited countries with greater incidence of the disease and in people who have had contact with them. As previously mentioned, the means of transmission is faecal-oral and it generally clears up with no complications.
Hepatitis B is transmitted in the majority of cases through sexual contact or by exchange of blood (drug addicts use of needles). Transmission via blood transfusion is currently very regulated and virtually never happens. In areas where the disease is very prevalent (mainly Asian countries) the most common means of transmission of hepatitis B is from mother to child during pregnancy or childbirth (vertical transmission). In these cases of vertical transmission, if adequate treatment is not administered, hepatitis B becomes chronic in more than 90% of cases.
Toxic hepatitis is caused by exposure to substances which are harmful to the liver. These toxins may be pharmaceuticals, natural products or others. In some instances the connection between the toxin and the hepatitis is very well documented and is predictable. In other instances an unexpected reaction takes place (idiosyncrasy). Finally, there are pharmaceuticals that do not produce hepatic toxicity unless they are used in much higher doses than normal (for example paracetamol).
Diagnosis is mainly clinical (observation of jaundice, dark urine) and from lab results (elevated liver enzymes and positive viral detection).
In addition, during the development of the disease the appearance or development of antibodies specific to each virus is detected, which determine the response of the patient and whether or not the condition becomes chronic.
An abdominal ultrasound allows us to see if there are any complications stemming from the acute hepatitis and to exclude other causes that might produce similar symptoms.
In general no specific treatment is needed for acute hepatitis except in some cases produced by hepatitis B and C viruses. Extreme personal hygiene is important to avoid contagion to others.
No specific diet is recommended (alcohol must always be avoided). Nor is total bed rest necessary (physical activity should be adapted to the patients general condition).
Basically these consist of analyses to show the status and development of the liver and how the patient is responding to treatment. Blood analyses can also reveal to what extent the condition is becoming chronic.
The best possible treatment for the A and B viruses is vaccination (included in the routine vaccination schedule). No vaccine is currently available for the C virus.
Hepatitis A is transmitted by faecal-oral contact (contaminated food and drink and from person to person). Food hygiene is fundamental here.
Barrier contraception methods (the condom) can prevent the transmission of sexually transmitted diseases (including hepatitis B and C).
In countries where the disease is very prevalent, many pregnant women may have the disease and transmit it to their child during the final phase of the pregnancy or the delivery. The use of +/- gamma globulin early vaccination against the hepatitis B virus can prevent infection in children.
Toxic hepatitis is prevented with caution to the exposure of the various toxins involved.
Scleroderma is an autoimmune disorder characterised by increased collagen in various body tissues, structural alteration of microcirculation and certain immune abnormalities. The term scleroderma comes from the Greek “skleros”, which means hard, and “derma”, which means skin. This indicates that skin hardening is the most characteristic feature of the condition. As well as the skin, it can also affect the digestive tract, lungs, kidneys and heart. The prognosis varies. There is currently no cure, but the condition can be treated with general measures and treatment of symptoms, depending on the organs affected.
Raynaud syndrome: one of the most characteristic manifestations of the condition (97% of cases), it is the first clinical expression in most patients. It is caused by vasoconstriction of the capillaries. Patients report that with the cold their fingers change colour and turn pale (like wax) first, then turn blue after a while and finally turn reddish. The presence of Raynaud syndrome is not always an indication of scleroderma. In reality, only 5% of people with Raynaud syndrome later develop the condition. Almost half of sufferers may have digital ulcers, as an expression of a severe microcirculatory injury.
The most peculiar manifestation of the disease is the way it affects the skin. It is hard, tight and wrinkle-free (hard to pinch). The extent of the skin condition varies and is related to the prognosis. Two clinical forms are distinguished: limited (distal skin condition to elbows and knees) and diffuse (distal and proximal skin condition to elbows and knees, and torso). The face can be affected equally in both clinical forms. The limited subtype has a better prognosis than the diffuse one. Reduced aperture of the mouth (microstomy) may also be seen. In the skin there are hyperpigmented and coloured areas, telangiectasia (accumulation of small blood vessels) and sometimes subcutaneous calcium deposits can be felt (calcinosis).
Most patients experience joint and muscle pain, and in extreme cases contraction and retraction of the fingers are observed. When the digestive tract is affected, which often happens, the patient complains of a burning sensation and difficulty swallowing, as the oesophagus has lost its ability to move food towards the stomach. Pulmonary disease is the leading cause of death and may occur in the form of fibrosis or pulmonary hypertension; coughing, choking and heart failure are the main manifestations of lung involvement. When the heart is affected, heart rhythm disturbances and in some cases symptoms of angina pectoris are detected, due to the involvement of the small coronary vessels. In a small percentage (about 5%) scleroderma alters the kidney (scleroderma renal crisis) and manifests itself as malignant arterial hypertension and kidney failure.
It should be noted that not all patients with scleroderma present all the manifestations described above. It can also be concluded that there is great, almost individual, variability in the clinical expression of the disease.
Scleroderma is a rare disease with an incidence of 4-18.7/million/year and a prevalence of 31-286/million. It is more common in females, with a variable ratio, depending on the series, ranging from 3:1 to 14:1 (female/male). The age at which it presents is around 30-40 years.
When the above symptomatology is clear, the diagnosis does not offer too much room for doubt. Various complementary tests are helpful in confirming diagnosis and in assessing the degree of involvement of the various organs that may be affected.
“An incurable, but not untreatable condition”. There is currently no treatment for scleroderma that has satisfactory results, but this does not mean that it cannot be treated. Treatment is symptomatic, depending on the organ affected. For Raynaud syndrome: vasodilators, antiplatelets; gastro-oesophageal reflux: proton pump inhibitors; renal crisis: angiotensin converting enzyme inhibitors/dialysis; pulmonary fibrosis: immunosuppressants/lung transplant; pulmonary hypertension: vasodilators/lung transplant. In patients with the diffuse form and less than three years of evolution, immune modulators such as mycophenolate sodium (or mycophenolate mofetil) or methotrexate may be indicated as a basic treatment.
The most common tests to confirm and/or assess the degree of involvement of the various organs are: general analyses and immunological data (specific antinuclear antibodies); capillaroscopy, high-resolution computerised axial tomography scan of the chest, respiratory functional tests, oesophageal manometry and echocardiogram. In the follow-up for these patients, respiratory functional tests and an echocardiogram should be performed annually.
The acceptance of these terms implies that you give your consent to the processing of your personal data for the provision of the services you request through this portal and, if applicable, to carry out the necessary procedures with the administrations or public entities involved in the processing. You may exercise the mentioned rights by writing to web@vallhebron.cat, clearly indicating in the subject line “Exercise of LOPD rights”. Responsible entity: Vall d’Hebron University Hospital (Catalan Institute of Health). Purpose: Subscription to the Vall d’Hebron Barcelona Hospital Campus newsletter, where you will receive news, activities, and relevant information. Legal basis: Consent of the data subject. Data sharing: If applicable, with VHIR. No other data transfers are foreseen. No international transfer of personal data is foreseen. Rights: Access, rectification, deletion, and data portability, as well as restriction and objection to its processing. The user may revoke their consent at any time. Source: The data subject. Additional information: Additional information can be found at https://hospital.vallhebron.com/es/politica-de-proteccion-de-datos.