Digestive System

Gastroenterology Unit

• Esophageal pathology
• Upper, lower or obscure gastrointestinal bleeding
• Inflammatory bowel disease
• Celiack disease
• Functional gastrointestinal disorders
• High-Risk Colon Cancer Clinic
• Proctology: non-surgical treatment of benign anorectal patology

Diagnostic and Therapeutic Endoscopy

The new Endoscopy Unit was inaugurated at the end of 2018. It integrates both the digestive and respiratory endoscopy units. In total, it has 9 procedure rooms, 3 of which are operating-theatre–type rooms equipped with ventilators to perform general anaesthesia, as well as a fluoroscopy C-arm, ultrasound equipment, and other devices required for highly complex procedures.

In addition, the unit includes a room for on-site cytopathological analysis related to endoscopic ultrasound-guided punctures, and a clinical classroom with an external connection system and image integration with the interventional rooms.

The service portfolio includes procedures ranging from conventional endoscopy to the most advanced and cutting-edge endoscopic techniques, such as therapeutic endoscopic ultrasound with the creation of anastomoses or biliopancreatic drainage, luminal therapeutic procedures for the removal of premalignant and malignant lesions, and endoscopic myotomies, with the continuous incorporation of emerging technological innovations.

The unit stands out for the high volume of procedures performed (morning and afternoon schedules), for being a reference centre for advanced endoscopic techniques throughout Catalonia, and for maintaining intensive research and teaching activities, leading clinical trials, supervising doctoral theses, and training endoscopists from other national and international centers.

Diagnostic Endoscopy

• Upper gastrointestinal endoscopy and colonoscopy
• Enteroscopy / capsule endoscopy
• Vital chromoendoscopy
• Endoscopic ultrasound (EUS) with or without guided puncture

Therapeutic Endoscopy

Lesion removal

• Polypectomy (simple and complex)
• Endoscopic mucosal resection and removal of subepithelial tumours

Hemostasis of bleeding lesions

• Injection therapy: adrenaline, alcohols, adhesives
• Electrocoagulation
• Mechanical therapy: clips, elastic bands
• Hemostatic powder

Other therapeutic procedures

• Foreign body removal
• Dilation of strictures and treatment of achalasia
• Stent placement in benign and malignant disease
• Closure of perforations and sealing of fistulas and dehiscences
• Treatment of Zenker’s diverticulum
• Treatment of Barrett’s esophagus: endoscopic mucosal resection, radiofrequency
• Endoscopic retrograde cholangiopancreatography (ERCP)

Therapeutic Endoscopic Ultrasound (EUS)

• Vascular therapy
• Celiac plexus block / neurolysis
• Injection therapy: botulinum toxin, cystic lesion ablation, antitumor agents
• Transmural drainage of collections (including necrosectomy), biliary and pancreatic drainage
• Creation of transmural internal anastomoses

Hepatology Section

The Hepatology Unit aims to establish itself as a clinical area of reference, patient-centred and dedicated to the comprehensive prevention, diagnosis and treatment of liver diseases. Its activity is carried out in accordance with scientific evidence and with the highest level of efficiency, integrating clinical care, research and teaching.

As a referral hospital, the population we serve includes 11 primary care centres (CAPs) in our surrounding area, covering approximately 280,000 inhabitants. In addition, we act as the reference centre for liver disease in southern Catalonia, serving a population of more than 2,000,000 people.

In terms of tertiary care, particularly notable are our liver transplantation programme, the management of patients with portal hypertension, and the comprehensive treatment of patients with hepatocellular carcinoma.

The Hepatology Unit is composed of hepatologists who are subspecialised in different areas (hepatitis, complications of cirrhosis, immune-mediated liver diseases, liver tumours, liver transplantation, etc.). They work alongside professionals from other departments and specialised nursing staff, integrated into different teams and multidisciplinary committees in order to provide high-quality, comprehensive clinical care for patients with liver disease.

Activities

• Viral Hepatitis
  • Diagnosis, treatment and follow-up with specialised nursing support
  • HCV micro-elimination programme: treatment in addiction care services (CAS), periodic review of RNA-positive cases, and HCV screening in the Emergency
• Department Autoimmune and Cholestatic Liver Diseases Diagnosis, monitoring and specialised treatment, including second- and third-line therapies
• Metabolic Liver Diseases Hepatic steatosis and alcohol-related liver disease Patient monitoring and management of risk factors in collaboration with the vascular risk unit and/or psychiatry services for addiction management
• Portal Hypertension
  • Management of bleeding from oesophageal, gastric and ectopic varices Endoscopic band ligation EUS-guided cyanoacrylate injection Coil placement Embolisation of gastric and ectopic varices TIPS placement Argon plasma coagulation
  • Management of portopulmonary hypertension
• Hepatocellular Carcinoma and Other Liver Tumours
  • Diagnosis and staging through a multidisciplinary committee (Digestive Surgery / Oncology / Radiology / Nuclear Medicine / Interventional Radiology / Hepatology / Clinical Nurse Specialist)
  • Comprehensive treatment: Surgical resection Liver transplantation Percutaneous ablation Chemoembolisation Radioembolisation Systemic therapy
• Complications of Cirrhosis Management of: Ascites Hepatic hydrothorax Hepatic encephalopathy Infections Renal failure / AKI-HRS Hepatopulmonary syndrome
• Acute Liver Failure and ACLF (Acute-on-Chronic Liver Failure) Aetiological diagnosis and management in a specialised critical care unit
• Rare Liver Diseases Management of: Wilson’s disease Haemochromatosis Hereditary haemorrhagic telangiectasia (Rendu-Osler disease) with hepatic involvement, in collaboration with the specialised unit
• Liver Transplantation
  • Assessment and evaluation of transplant candidates
  • Immediate post-operative care of transplant recipients
  • Outpatient follow-up of long-term complications after liver transplantation Prevention and screening of de novo malignancies Cardiovascular risk factor management Hepatology
• Day Hospital
  • Paracentesis and thoracentesis
  • Monitoring of patients with cirrhosis receiving diuretic therapy, chronic anaemia or chronic hepatic encephalopathy
  • Initiation of beta-blocker therapy for portal hypertension
  • Assessment of minimal hepatic encephalopathy
  • Follow-up of patients after hospitalisation for severe acute hepatitis
  • Monitoring of cirrhotic patients reviewed in the Emergency Department due to decompensation

Services Provided

• Specialist hepatology outpatient clinics
• Hepatology day hospital
• Hepatology inpatient ward
• Liver transplantation inpatient unit
• Inpatient consultation service
• Short-stay hospitalisation unit
• Virtual hepatology consultations with primary care services
• Liver elastography
• Specialist liver disease nurse
• Hepatocellular carcinoma multidisciplinary committee
• Liver transplantation committee

Procedures (in collaboration with other specialities)

• Endoscopic band ligation / APC / radiofrequency / capsule endoscopy
• Hepatic haemodynamics – TIPS
• Embolisation of ectopic varices
• Porto-mesenteric revascularisation
• Percutaneous ablation / TACE / TARE
• Systemic treatment for hepatocellular carcinoma with specialised oncology teams
• Percutaneous liver biopsy and biopsy of liver lesions
• Transjugular liver biopsy
• Hepatic surgery – liver tumour resection
• Liver transplantation
• Specialised liver pathology services
• Intensive care medicine: management of patients with acute liver failure, ACLF and severe cirrhosis decompensation requiring admission to intensive care units
• Right-heart catheterisation for the assessment of portopulmonary hypertension

Microbiome Unit – Faecal Microbiota Transplantation

Microbiome Unit – Faecal Microbiota Transplantation

The Bellvitge University Hospital has become a reference centre for faecal microbiota transplantation (FMT) and the study of the human microbiome. The hospital also hosts one of the sites of the Catalonia Microbiota Bank.

The Microbiota Bank selects optimal stool donors while processing and storing faecal samples for FMT with the highest standards of safety and quality. Furthermore, the Bank ensures accessible and equitable application of this therapy across the region.

Faecal microbiota transplantation involves transferring a solution prepared from the stool of healthy donors to restore or rebalance a compromised intestinal microbiota. FMT is the treatment of choice for recurrent Clostridioides difficile infection, as recommended by leading clinical guidelines and medical societies. In recurrent C. difficile infection, FMT is a cost-effective therapy with overall cure rates of 87–89%.

In 2014, our centre performed its first FMT to treat recurrent C. difficile infection. Since then, numerous patients have benefited successfully from this therapy. At Bellvitge University Hospital, we work with a multidisciplinary and cross-departmental team, which led to the creation of the Microbiome Unit, involving gastroenterologists, microbiologists, nursing staff, and laboratory technicians. Facilities have been adapted, and the bioinformatics tools necessary for human microbiome analysis are available.

FMT can be administered primarily via colonoscopy or oral lyophilised microbiota capsules. At our centre, both methods are available. Since 2021, we have the technology and infrastructure to produce lyophilised capsules, which can be taken orally by patients who require this mode of administration.

Microbiome Unit Team

I WANT TO BECOME A FAECAL MICROBIOTA DONOR

At our centre, we have been performing FMT for over ten years, a process that would not be possible without the selfless contribution of donors.

To become a faecal microbiota donor, candidates must be healthy, with no significant personal or family medical history. It is also important to avoid medications excreted in stool or those that may alter gut microbiota.

Each donor undergoes a comprehensive screening prior to donation, including a detailed questionnaire, blood tests, nasal swab, and stool analysis. If you are interested in becoming a donor, please contact us via the Blood and Tissue Bank.

Contact:

microbiota@bellvitgehospital.cat

Digestive Functional Testing Unit

Digestive Functional Testing Unit

The Digestive Functional Testing Unit at Bellvitge University Hospital carries out specialised investigations for the assessment of functional gastrointestinal disorders and gastrointestinal motility. The unit is staffed by experienced clinicians and specialised nursing staff and is equipped with state-of-the-art technology to ensure high-quality care.

Digestive Functional Testing Unit

Team Tests Performed in the Unit

High-Resolution Oesophageal Manometry

High-Resolution Oesophageal Manometry with Impedance

This test allows the assessment of the motor function of the oesophagus, pharynx, and the upper and lower oesophageal sphincters.

When combined with impedance, it also evaluates the movement and clearance of oesophageal contents.

Procedure:

A solid-state catheter with internal pressure sensors is inserted through the nasal passages into the stomach. The study is performed using liquid swallows in both lying and sitting positions. In some cases, a solid meal may be included.

Main Indications:

• Dysphagia (difficulty swallowing)
• Non-cardiac chest pain
• Assessment of gastro-oesophageal reflux disease (GORD), including localisation of the lower oesophageal sphincter prior to pH monitoring or as part of preoperative evaluation for anti-reflux surgery
• Assessment of oesophageal involvement in systemic diseases, e.g., scleroderma
• Suspected rumination syndrome
• Suspected supragastric belching syndrome

24-Hour Oesophageal pH Monitoring

This test quantifies and characterises acid gastro-oesophageal reflux over 24 hours and assesses its relationship with the patient’s symptoms.

Procedure:

A thin catheter is inserted through the nasal passages to the distal third of the oesophagus and connected to a recording device worn by the patient for 24 hours.

Indications:

• Confirmation of GORD diagnosis in patients unresponsive to standard treatment
• Assessment of atypical symptoms such as chronic cough, asthma, laryngitis, or dysphonia

24-Hour Oesophageal Impedance-pH Monitoring

This technique detects acidic, weakly acidic, and alkaline reflux, and characterises reflux episodes in patients under anti-secretory therapy.

Indications:

• Refractory gastro-oesophageal reflux
• Suspected frequent belching associated with supragastric belching or rumination syndrome High-Definition 3D Anorectal Manometry This test evaluates the function of the anal sphincter and pelvic floor muscles using three-dimensional imaging.

Procedure:

A solid-state catheter with pressure sensors is inserted through the anus and rectum. Measurements are taken at rest and during physiological manoeuvres (squeezing, coughing, and simulated defecation). In some cases, the study is completed with an expulsion test.

Indications:

• Chronic constipation
• Faecal incontinence
• Anal pain
• Preoperative assessment of anorectal function

Breath Tests

Involves ingestion of a sugar solution and subsequent measurement of hydrogen and methane in the exhaled breath.

Indications:

• Diagnosis of small intestinal bacterial overgrowth (SIBO)
• Assessment of carbohydrate intolerances

Liver Elastography

Also known as FibroScan, this is a non-invasive, simple, and rapid test that measures liver stiffness (fibrosis) and the degree of steatosis (fat content). It allows for improved diagnosis and monitoring of liver disease without the need for a biopsy.

Inflammatory Bowel Disease (IBD) Functional Unit

Inflammatory Bowel Disease (IBD) Functional Unit

Inflammatory Bowel Disease (IBD) primarily includes ulcerative colitis and Crohn’s disease. At the IBD Unit of Bellvitge University Hospital, we provide comprehensive, personalised care to help you manage your condition, prevent complications, and maintain the best possible quality of life.

What We Offer

We work with a multidisciplinary approach, coordinating specialists and diagnostic tests within a pathway designed to provide efficient, safe, and evidence-based care.

Our Commitment

• Patient-centred care, with shared goals and an individualised care plan
• Personalised medicine, with decisions reviewed by a multidisciplinary committee (Gastroenterology, General and Digestive Surgery, Radiology, Hospital Pharmacy, Rheumatology, and Dermatology)
• Responsible and sustainable use of diagnostic and therapeutic resources
• Support for equity, providing clinical and educational support to centres across our healthcare area

Your Care Pathway in the Unit

1. Initial Consultation: Complete assessment, review of tests, and definition of the diagnostic-therapeutic plan, including initial education (treatment, warning signs, and follow-up).
2. Follow-Up: Visits scheduled according to activity and treatment, with monitoring via blood tests, biomarkers, endoscopy, or imaging as required.
3. High-Resolution Consultation (preferred): For symptom worsening, suspected flare, or new diagnoses, aimed at accelerating decisions and initiating or adjusting treatment (as clinically indicated).
4. Specific Programmes: Training in administration of biologic therapies Management of extra-intestinal manifestations (skin, joints, eyes) Care for patients with ostomies (stoma care nursing)

If you experience severe symptoms (intense pain, persistent high fever, dehydration, heavy bleeding, or rapid deterioration), please attend the Emergency Department immediately.

Clinical Services

• Specialist consultations: Gastroenterology and Digestive Surgery focused on IBD
• Specialised nursing: Therapeutic education, support with self-care, and remote follow-up (phone/email) according to protocol
• Day Hospital: Administration of parenteral therapies and priority assessment within the high-resolution pathway
• Advanced Endoscopy: Diagnostic and therapeutic endoscopy, chromoendoscopy, and capsule endoscopy when indicated
• Hospital Pharmacy: Dispensing and support to improve adherence; when appropriate, personalised monitoring and dosing using pharmacokinetic models to optimise efficacy and safety
• Multidisciplinary Support: Coordination with Rheumatology, Dermatology, Nutrition and Dietetics, Radiology, Stoma Care, Clinical Pharmacology, Ophthalmology, and Pathology, among others

Innovation, Research and Clinical Trials

We participate in clinical and translational research in collaboration with IDIBELL and a Clinical Trials Unit.

ENEIDA Registry (GETECCU): We are a collaborating centre in ENEIDA, a national registry and biobank promoting clinical and genetic studies in IBD.

Why participate? Your contribution, together with many others, helps collect real-world data and accelerate understanding of IBD progression. This leads to better recommendations, more effective treatments, and safer decisions, advancing personalised medicine. Participation is voluntary and conducted under ethical and data protection standards.

Clinical Trials: Where an appropriate study exists, patients may be offered participation. Participation is voluntary, with informed consent, and conducted under strict ethical supervision.

Education and Support for the Healthcare Network

In addition to clinical activity, we promote continuing education and provide support to professionals and centres in the area to ensure consistent, high-quality care.

Useful Links

• El meu HUB
• GETECCU (Spanish Working Group on Crohn’s and Ulcerative Colitis)
• ENEIDA Project (GETECCU) – Patient Information
• Educainflamatoria – Educational Platform for IBD

Pancreas Unit

Pancreas Unit

The Pancreas Unit at our hospital is a reference centre for the diagnosis and therapeutic management of patients with pancreatic disease.

Pancreatic conditions can be broadly classified into four main areas: acute pancreatitis, chronic pancreatitis, pancreatic cystic lesions, and pancreatic tumours. Acute pancreatitis is one of the most frequent causes of admission to General and Digestive Surgery and Gastroenterology services. Pancreatic cancer is a leading cause of cancer-related death, with incidence rates continuing to rise. The management of pancreatic cystic lesions is evolving, and clinical decision-making can be complex.

Pancreatic diseases are often complex and require a multidisciplinary approach. Our team comprises specialists in surgery, gastroenterology, radiology, endoscopy, interventional radiology, endocrinology, nutrition, oncology, pathology, infectious diseases, and intensive care, all with expertise in pancreatic disease management. We hold regular meetings to review complex cases and make joint clinical decisions. We have state-of-the-art technology for addressing diagnostic and therapeutic challenges of pancreatic disease, and our team has many years of experience to provide the best possible care. Our professionals are members of scientific societies related to various aspects of pancreatic disease and actively participate in educational and research activities to advance knowledge in the field.

Unit Activities Inpatient Care:

• Comprehensive management of hospitalised patients, integrating medical and surgical care
• Short-Stay Hospital Unit: For planned endoscopic or radiological procedures
• Outpatient Clinics: Gastroenterology and General & Digestive Surgery consultations
• Multidisciplinary Committees and Clinical Sessions:
  • Hepato-Bilio-Pancreatic Clinical-Radiology Sessions
  • Multidisciplinary Pancreatic Cancer Committee
  • Neuroendocrine Tumour Committee
• Treatment of Patients with Acute Pancreatitis
  • Nutritional assessment for patients with severe acute pancreatitis (enteral, parenteral, or combined nutrition)
  • Multidisciplinary step-up approach for infected necrosis: Radiological percutaneous drainage Endoscopic transmural drainage Surgery for severe acute pancreatitis: VARD (Video-Assisted Retroperitoneal Debridement) and open surgery
  • Embolisation of vascular lesions.
• Treatment of Patients with Chronic Pancreatitis
  • Medical management of chronic pancreatitis
  • Diagnosis and treatment of exocrine pancreatic insufficiency
  • ERCP and biliary stent placement for biliary strictures
  • Drainage of pancreatic collections
  • Endoscopic treatment of Wirsung duct stones Surgery for chronic pancreatitis

​​​​​​​Research

• Active participation in conferences and courses on pancreatic disease
• Ongoing studies led by our centre: Multicentre Clinical Trial on home management of mild acute pancreatitis
• Participation in multicentre studies led by other hospitals

Oesophagogastric Disorders Unit

Oesophagogastric Disorders Unit

Within the Gastroenterology Unit, the Oesophagogastric Disorders Unit is dedicated to the diagnosis and multidisciplinary management of oesophageal and gastric diseases.

This subunit is composed of consultant gastroenterologists who work closely with professionals from other departments and specialities, including General and Digestive Surgery, Radiology, the Endoscopy Unit, the Digestive Functional Testing Unit, Pathology, Speech and Language Therapy, and Endocrinology and Nutrition, among others.

We run several specialised outpatient clinics focused on the management of these conditions, where we care for both our own patients and those referred from across the healthcare network.

We treat a wide range of conditions, including preneoplastic oesophagogastric disease, neuroendocrine tumours, oesophagogastric motility disorders, peptic disease, gastro-oesophageal reflux and its complications, and oesophageal strictures of various causes, among others.

In addition, we actively participate in the Oesophagogastric Tumours Unit and the Oesophageal Motility Disorders Unit, where complex cases are discussed jointly with other specialists to determine the most appropriate management. We also collaborate in the performance of diagnostic and therapeutic endoscopic procedures for specific conditions, including oesophageal motility disorders.

Finally, we contribute to research activities, taking part in several clinical trials, and maintain continuous professional development through participation in national congresses, specialised courses, and training workshops in our field.

Liver Transplant Unit

Liver Transplant Unit

The University Hospital of Bellvitge has had a liver transplant (LT) programme since 1984, when the first LT in Spain was performed. Since then, more than 2,000 patients have undergone transplantation, with outcomes comparable to those of the best centres worldwide.

The Liver Transplant Unit (LTU) is a multidisciplinary unit comprising several departments (Radiology, Intensive Care, Infectious Diseases, Pathology, Anaesthetics, etc.) and is led by the Hepatology Unit of the Gastroenterology Department and the Hepatobiliary Surgery Unit of the General and Digestive Surgery Department. It has its own inpatient ward, a specialist nurse, and dedicated outpatient clinics.

SERVICES ASSOCIATED WITH THE LIVER TRANSPLANT UNIT

1. Dedicated inpatient ward staffed by two hepatologists, a liver surgeon and a specialist nurse, as well as gastroenterology and surgical residents. This ward admits patients in the immediate post-operative period following LT, transplant recipients readmitted due to medical or surgical issues, and others admitted for investigations, tests or treatments.
2. Dedicated outpatient clinics for LT, covering both medical and surgical aspects. Dressings and minor procedures can also be carried out in the outpatient setting.
3. Specialist nursing outpatient clinic for LT. This provides patient follow-up, health education, immunosuppression review, and addresses queries and minor issues.
4. Telephone and email support provided by specialist LT nursing staff. This service is available to patients, relatives, and healthcare professionals involved in the patient’s care at other levels or for other conditions.
5. LT Committee. Composed of hepatologists and LT surgeons, along with specialists from other departments with specific expertise in transplant-related conditions: infectious disease specialists, radiologists, pathologists, anaesthetists, etc. It meets weekly to assess both candidates and transplant recipients with complications.

SERVICES PROVIDED

• Monitoring of patients on the waiting list in collaboration with the Hepatology Unit
• Immediate post-operative management of transplant recipients
• Inpatient consultations for LT patients admitted to other departments or centres
• Handling of specialist enquiries from other hospitals
• Presentation of transplant recipients at the Liver Transplant Committee
• Outpatient follow-up of long-term complications of liver transplantation, including prevention and screening of de novo malignancies and management of cardiovascular risk factors
• Coordination with other levels of care (Primary Care, general hospitals) to provide comprehensive patient management
• Representation on the Advisory Committee for LT of the Catalan Transplant Organisation (OCATT)
• Maintenance of the unit’s databases and reporting of transplant patient data to official bodies (OCATT, ONT)
• Participation in national and international research studies and clinical trials