Nutrition and Intestinal Failure
With the opening of a new NSCAG-approved Intestinal Failure Unit, 'The Lennard-Jones IF Unit', St Mark's is committed to enlarging its role as one of two national referral centres for patients with intestinal failure (IF). The aims are to facilitate greater access for patients to a specialist centre, to reduce the severity of intestinal failure, to increase patient confidence through enhanced education & support and to provide national and international leadership & role modelling, in clinical care, research and teaching. Last year the unit dealt with 85 referrals of patients with IF. The unit is staffed by a multidisciplinary team that includes physicians, surgeons, medical and surgical registrars, and highly specialised dieticians, nurses, and pharmacists. These teams offer a comprehensive approach to malnourished patients receiving parenteral nutrition or enteral nutrition. These forms of therapy are dependant on a specialised service to achieve successful outcomes. The role of the team is to perform a nutritional assessment, design a nutrition regime, addresses electrolyte/metabolic derangements whilst continuing to offer support for education and training with nutritional support. The nutrition service also offers advice for other high-risk patient groups who are receiving enteral or parenteral nutrition and those who are scheduled for surgery. All members of the multidisciplinary team are involved in research activities and are committed to medical education.
The unit is staffed by:
Dr Simon Gabe, Dr Jeremy Nightingale, Miss Carolynne Vaizey, Mia Small, Sam Kay, Sally Crowther, Dr Alison Culkin, Morag Pearson, Diane Brundrett, Yeekee Chung and Jackie Eastwood.
Services
Enteral nutrition and nutritional support
Facilitate nutritional support across the Trust
Development of a nutrition steering committee for the Trust, in keeping with the NICE guidelines due for release in 2006.
Take a leading role in publishing national guidelines
Referring patients to nutrition team/IF unit
The Lennard-Jones Intestinal Failure Unit currently offers nutritional services at St Mark's Hospital.
Criteria for referral to the Intestinal Failure Unit are as follows;
1. Intestinal failure for over 6 weeks without evidence of resolution
2. Intestinal fistulae
a. Multiple fistulation in a dehisced abnormal wound
b. Outside the expertise of the referring unit.
3. Short bowel syndrome
a. Total/near total small bowel enterectomy (<30cm residual SB)
b. Metabolic complications
4. Intravenous nutrition (IVN) complications
a. Venous access complications on IVN
b. Recurrent severe infections or venous thrombosis
c. Hepatic or renal dysfunction (problematic)
5. Persistent intra-abdominal sepsis
a. Not responding to radiological/surgical drainage and nutritional support
For intestinal failure referrals please contact the IF Coordinator on 0208 235 4009
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