The Department of Gastroenterology, IBD and Nutrition Support is involved for over 40 years in the field of rare intestinal diseases causing intestinal failure (IF). Former head of the Department, Pr Bernard Messing, was a pioneer in developing parenteral nutrition (PN) in adult patients in the late 70's. He participated to the creation of the first’s French approved center for home-PN.
In 2004, our department has become one of the constitutive, certified centers of the National Reference Center for Rare Intestinal Disease (“Centre des MarDi ) which has been recognized as the French reference center for rare intestinal diseases. Our international contribution in this field is illustrated by
a) the promotion of the concept of the Intestinal Rehabilitation Center for Intestinal Failure by organizing a close collaboration with a unique expertise in rehabilitative surgery for complex cases of short bowel and patients with motility disorders. Although the role of transplantation is decreasing worldwide in the management of irreversible IF, our intestinal transplantation program is one of the 2 ongoing programs in France for adult patients.
b) the involvement in an European group of the Home Artificial Nutrition (enteral and parenteral) and Chronic Intestinal Failure (Chair: Loris Pironi) from the European Society for Clinical Nutrition and Metabolism (ESPEN) to perform clinical and epidemiological studies in the field of HAN and of CIF and to provide guidelines for HAN and for CIF.
c) A close contact with two centers of basic research (INSERM, UMR1149 Unit and INRA, UMR1319 MICALIS Unit) with the development of a pre-clinical model of short bowel syndrome (the principal cause of intestinal failure) and with a knowledge improvement in mechanisms of intestinal adaptation in short bowel syndrome.
Furthermore, our center provides all aspects of multidisciplinary medical and surgical therapies to treat chronic intestinal failure and prevent the metabolic and septic complications due to home parenteral nutrition. With more than 300 adult patients requiring HPN for chronic intestinal failure, the center performs a specific coordination between hospital and home with dedicated nurses, dietician and physicians. At the same time, a very special focus on children with CIF becoming adults has been developed. We provide a specific program of transition between pediatric hospitals and our center.
Our department has developed specific innovative programs focused on
a) prevention of short bowel with a specific department of acute intestinal ischemia lead by Pr Olivier Corcos,
b) development of the monitoring and usage of new drugs to improve intestinal absorption in SBS patients (largest cohort in the world treated with GLP2 agonist),
c) development with “partner/expert” patients of new tools such as mobile application to collect at home data necessary for the follow up.