Intestinal Failure care in Spain Where is care provided? Children and adults with intestinal failure are treated in specialised centers within the national health service. These hospitals provide multidisciplinary expertise in intestinal rehabilitation and parenteral nutrition. Your GP or local hospital can refer you to one of these centers. Psychological & Social Support Support is available for both patients and parents: Hospital psychologist Support from multidisciplinary IF teams Ask your treating center which services are available locally. Home Parenteral Nutrition (HPN) If your child needs home parenteral nutrition: HPN is fully covered by the national health service Equipment and supplies are arranged through healthcare providers Costs and reimbursement In Spain: Medical specialist care is covered by the national health service HPN is also fully funded by the national health service No specific additional funding applications are required If unsure, families may contact: Their hospital social worker Their local health service office School and education Support may include: Hospital teacher during hospitalisation Patient organisations NUPA – national patient organisation for intestinal failure, home parenteral nutrition and transplant.

Esophageal diseases ERNICA covers the following diseases within the esophageal diseases working group. Esophageal Atresia Esophageal atresia is a birth defect in which the esophagus, which normally connects the mouth with the stomach, is interrupted. Read Less Read More Achalasia In the case of achalasia, this lower esophagus muscle does not work properly Read More Read Less Congenital Esophageal Stenosis Congenital esophageal stenosis (CES) is manifested as an intrinsic narrowing of the esophagus present at birth. Eosinophilic Esophagitis Eosinophilic esophagitis (EoE) is an inflammation of the esophagus (the tube connecting the mouth to the stomach), caused by a specific white blood cell – the eosinophil. Read more Read less Esophageal Atresia Esophageal atresia is a birth defect in which the esophagus, which normally connects the mouth with the stomach, is interrupted. The medical definition of ‘atresia’ is the following: absence or closure of a natural passage of the body. Different types of malformation The normal anatomy of the esophagus and respiratory tract shows a direct connection of the esophagus to the stomach and the windpipe to the lungs. There is no connection between the two. The figure below shows the different types of Esophageal atresia. Type A: Esophageal atresia without tracheoesophageal fistula (8%): With this type, a large part of the esophagus, so-called long-gap, is missing and there is no connection to the trachea. This distance has to be bridged: depending on the distance to be bridged, the surgical technique is determined. Type B: Esophageal atresia with a proximal tracheoesophageal fistula (1%): In this case, not only is part of the esophagus missing, but there is also a connection (fistula) between the upper (proximal) part and the trachea. Saliva or food goes via the fistula to the lungs, instead of to the stomach. The lower part of the esophagus ends blindly. The atresia is often long-gap. Type C: Esophageal atresia with a distal tracheoesophageal fistula (85%): This is the most common type. There is a connection between the lower (distal) part of the esophagus and the windpipe, which means a direct connection between the stomach and the airways. The upper half of the esophagus ends blindly. During breathing the child suffers from the accumulation and overflow of saliva from the closed "pouch". In addition, the lungs can be irritated from gastric fluid flowing through the connection with the windpipe in the lower part of the esophagus. Type D: Esophageal atresia with both a proximal and a distal tracheoesophageal fistula (1%): Here we find a combination of both types B and C. This type has a double fistula connection: the upper and lower Esophageal stumps both end into the trachea. Through these two connections, both saliva and stomach contents can go to the lungs. Type E: Tracheoesophageal fistula without atresia (H-fistula) (4%): With this type, the esophagus has normally developed but there is a connection between the esophagus and the windpipe. This type is usually only noticed a few days or even weeks after birth because there is a passage to the stomach. This allows a child to drink normally. However, food and saliva may enter the lungs, causing the child to choke or having trouble breathing. Type F: Esophageal stenosis (1%): There is no connection between the esophagus and the trachea, but the esophagus is constricted. The narrowing can be so severe that nutrition and/or saliva cannot pass through to the stomach. Consensus statements Three consensus statements on Esophageal Atreasia are developed within ERNICA 1. Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management. HTML version PDF 2. Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Follow-up and Framework. HTML version PDF 3. P erioperative, surgical and long-term managemen t of patients with long-gap esophageal atresia. HTML version Informative videos about Esophageal Atrasia Play Video Share Whole Channel This Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied Search videos Search video... Now Playing 06:46 Play Video An Introduction to OA/TOF | What is OA TOF? [EA/TEF] Now Playing 03:43 Play Video Esophageal Dilation for children with Esophageal Atresia Now Playing 03:00 Play Video LIFE - Lifelong Follow up for Esophageal atresia Other resources Kinder- und Jugendmedizin Supplement on Esophageal Atresia Achalasia A sphincter, which is a kind of ’valve’, controls the passage of food from the esophagus to the stomach. It is a bundle of muscle fibres that opens up when food goes from the esophagus to the stomach. Immediately after that, the sphincter closes to prevent the backward flow of gastric juices into the esophagus. In the case of achalasia, this lower esophagus muscle does not work properly: it does not relax sufficiently, so that food remains in the esophagus after swallowing. This is because the nerves that control this sphincter are affected. Another characteristic of achalasia is the lack of the normal rhythmic contractions of the esophagus (wave movements) that propel the food from top to bottom into the esophagus. Probably this is also due to an impairment of the nerves. Achalasia can occur at any age, but usually starts between 20 and 40 years. It can remain unnoticed for a long time and gradually increase over the years. Eosinophilic Oesophagitis WHAT IS EOSINOPHILIC OESOPHAGITIS? Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease of the oesophagus, characterised by frequent vomiting, difficulties in swallowing (dysphagia), difficulties in eating and drinking, and abdominal pain. From a biopsy, an infiltration of the epithelium by white blood cells (eosinophils) is observed. Eosinophils are key cells in the innate immune system of the gastrointestinal tract. They protect the organism against parasitic infections and are usually present throughout the entire gastrointestinal tract, with the exception of the oesophagus. Eosinophilic oesophagitis is a rare cause of dysphagia, but its prevalence is unknown. HOW IS THIS PATHOLOGY DIAGNOSED? The disease often evolves over several years before being diagnosed. This delay in diagnosis is mainly due to adaptation by the subject, who will create strategies to eat more slowly, chew foods well and use liquids to aid in swallowing food. The reasons for seeking medical advice and the main complaints are difficulties in swallowing solids, food bolus impaction or gastro-oesophageal reflux symptoms. The diagnosis of eosinophilic oesophagitis is suspected based on clinical or endoscopic information and is confirmed with oesophageal biopsies. Infiltration of the oesophageal mucosa by eosinophils is a mandatory symptom for making the diagnosis; however, it alone is not sufficient to define the disease. WHAT IS THE TREATMENT? The therapeutic objective is to obtain clinical and histological remission. Histological remission would in particular enable a decrease in the risk of evolution towards stenosis. First-line therapy is based on proton pump inhibitors, which help to relieve the symptoms and reduce inflammation in approximately 40% of patients. In case of failure, treatment is based on swallowed topical steroids, but instructions for use must be clearly explained to the patient. Dietary therapy can also help obtain clinical and histological remission in approximately 75% of cases.

< Back Karolinska University Hospital Sweden This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Duodenal And Small Bowel Atresia Esophageal Atresia Gastroschisis Intestinal Failure Morbus Hirschsprung Necrotizing Enterocolitis Omphalocele Sacrococcygeal teratoma Previous Next

< Back Skånes universitetssjukhus Sweden This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Esophageal malformations Gastroschisis Morbus Hirschsprung Omphalocele Previous Next

< Back Radboud UMC Netherlands This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Morbus Hirschsprung Previous Next

< Back ERNICA Webinar on Hirschsprung Disease: The Failing Pull-Through Sep 3, 2026 ERNICA Webinar on Hirschsprung Disease: The Failing Pull-Through - Thursday, 3 September 2026, 4-5PM CEST How should we evaluate a patient with Hirschsprung disease who is not doing well after their pull-through? Join our upcoming webinar, “Hirschsprung Disease: The Failing Pull-Through,” for expert insights into the assessment and management of these complex cases. Speakers include: Dr. Marc Levitt, George Washington School of Medicine Dr. Jan-Hendrik Gosemann, University of Leipzig Medical Centre You can register here . We look forward to seeing you there! Previous Next

< Back UZ Leuven Belgium This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Congenital Hiatus Hernia Duodenal And Small Bowel Atresia Eventration Of Diaphragm Gastroschisis Necrotizing Enterocolitis Omphalocele Previous Next

< Back Fondazione Policlinico Universitario A. Gemelli Italy This centre has expertise for ERNICA in: Achalasia Familial Adenomatous Polyposis Intestinal Polyposis Syndrome Previous Next

< Back Universitätsklinikum Bonn Germany This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Duodenal And Small Bowel Atresia Gastroschisis Necrotizing Enterocolitis Omphalocele Previous Next

< Back UZ Gent Belgium This centre has expertise for ERNICA in: Congenital Diaphragmatic Hernia Duodenal And Small Bowel Atresia Esophageal Atresia Gastroschisis Intestinal disease due to fat malabsorption Morbus Hirschsprung Necrotizing Enterocolitis Omphalocele Rare Inflammatory Bowel Diseases Sacrococcygeal teratoma Short Bowel Syndrome Previous Next

Training and Education ERNICA develops and implements online and face-to-face educational/training activities targeted towards medical professionals, patients and families. Through its cross-border training activities, ERNICA aims to build capacity and increase access to expertise at EU level. TRAINING AND EDUCATIONAL ACTIVITIES Flagship programme The Flagship Surgical Training Programme is a joint initiative of ERNICA and eUROGEN, aimed at building sustainable expertise in highly complex and ultra-rare surgical procedures across Europe by increasing high-potential young consultants' exposure to real surgical cases of high complexity and educational value. Click here for more information. Webinars ERNICA also engages in live joint educational webinars with eUROGEN, EUPSA and Research Collaboration Webinars. You can find recorded versions of these webinars on our YouTube channel. . The joint webinars with eUROGEN are specifically focused on ARM and Hirschsprung's Disease ('colorectal series'). For more information on registration click here . Courses ERNICA organises hands-on colorectal and CDH surgical training courses, with support from ERNICA member centre Radboud MC, EUPSA and eUROGEN. Please find out more here . Other eductional activities ERNICA has set up its own YouTube channel for the dissemination of relevant e-learning and video content for healthcare professionals and/or patients and their families. . ERNICA has also organised joint educational sessions with supporting partners, such as the ERNICA-ESPGHAN Educational Session on Feeding, Nutrition and Growth in Esophageal Atresia Patients. Other educational activities ERNICA-ESPGHAN Educational Session on Feeding, Nutrition and Growth in Esophageal Atresia Patients ERNICA Artificial Intelligence Session

< Back ERNICA Annual Meeting 2027 Postponed Jun 2, 2026 The ERNICA Annual Meeting 2027 will be postponed to autumn 2027, with the exact dates to be confirmed at a later stage. This decision has been taken after careful consideration of the current budget situation. At present, available resources do not allow us to organise a meeting that meets the high standards of inclusivity and participation that have characterised previous ERNICA annual meetings. As broad participation is essential for meaningful scientific exchange and networking within our multidisciplinary community, the postponement will provide an opportunity to secure additional funding through a potential new grant. This will help ensure a high-quality meeting with strong representation from across the ERNICA network. We thank all members and partners for their understanding and continued support. Further updates, including confirmed dates, will be shared as soon as they become available. Previous Next