Lives being lost due to lack of Intestinal Failure service


Experts call out Government on gap in care for Intestinal Failure

Experts at an international conference on nutrition today have said lives are being lost – and called out the Government on the lack of a specialist service for Intestinal Failure.


Speakers at the conference on nutrition and health in Dublin, hosted by the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), said the situation was a ‘national disgrace’ – and called for urgent approval of a dedicated adult Intestinal Failure (IF) Unit in line with health services across Europe.


IrSPEN President and Consultant Gastrointestinal Surgeon Professor John Reynolds said there is ‘no excuse’ for not taking action, as it would end suffering and deaths that are avoidable.


“Despite a decade of campaigning to establish a dedicated service for adult Intestinal Failure patients, with promises from Government Ministers and meetings with HSE Executives, Ireland continues to lack a needed specialist service.


“The case for establishing a dedicated Unit at St. James’s Hospital has been accepted by policy makers, and has the support of all the expert groups and professionals.


“A detailed proposal, was originally submitted to Government and the health services in 2017, then re-submitted last year and remains under consideration. We know that this service is literally a matter of life or death and it must be prioritised.”


“The costed budget for such a Unit is €6m per annum, but a significant portion of this cost would be offset by the service not being needed elsewhere in the health service. This proposal was supported by the then Minister for Health Simon Harris in 2017, but never followed through,” he said.


Each year approximately 100 adults in Ireland develop severe acute Intestinal Failure (IF) with a requirement for highly specialised care.


IF occurs when a patient’s intestine cannot digest food and absorb fluids. Patients must be fed artificially via liquid nutrition through a catheter or needle inserted into a central vein in the chest. The treatment is lifesaving, but the risk of serious complications is high if not managed extremely carefully, resulting in emergency hospital admissions, prolonged hospital stay and death.


Also speaking at the conference, the President of the European Society for Clinical Nutrition and Metabolism (ESPEN) Professor Rocco Barazzoni said Ireland was an outlier in its lack of a specialised service to treat Intestinal Failure. “IF patients face high morbidity and mortality risks – and Ireland should be taking steps to provide a dedicated national centre.”


Consultant Gastroenterologist at St. James’s Hospital Dr. Cara Dunne said avoidable deaths are happening and must end.


“Much of the medical expertise needed is already in place at St. James’ hospital and what’s now needed is additional funding to develop this into a specialised Unit that is dedicated to these patients.


“Research from the NHS in the UK has equated under-capacity within Intestinal Failure care with 150 avoidable deaths each year. This would equate to 12 avoidable deaths per year in Ireland. Currently, Northern Ireland has a 12-bed IF unit for 1.6 million – in contrast there is no dedicated Unit in this country for five million,” Dr. Dunne said.


The theme of today’s conference is on the role of muscle in aging and disease and titled Fit to Function: a new focus on muscle and aging and disease.


Addressing delegates, Professor John Reynolds also said that there is need for better public and professional awareness on the role of muscle in well-being as people get older, particularly during cancer care.


“Current medical research clearly links the maintenance of muscle mass and function during cancer care with improved outcomes. Losing weight and losing muscle mass are common problems in cancer – affecting at least a third of patients, and has the potential to make treatment less effective and increases the risks of complications.


“A modern goal in cancer care is to minimise weight change during treatment and to preserve as best we can muscle mass and function,” he said.


More information on today’s conference is at www.irspen.ie/irspen2023


Further Information

Ronan Cavanagh, Cavanagh Communications: (086) 317 9731 / ronan@cavanaghcommunications.ie