Department of Gastroenterology and Hepatology - University Hospital Ulm

About the Department of Gastroenterology and Hepatology at University Hospital Ulm

The Department of Gastroenterology and Hepatology at the University Hospital Ulm specializes in providing comprehensive medical care to patients with diseases of the gastrointestinal tract, liver, gallbladder, and bile ducts. One of the primary clinical focuses of the department's doctors is the diagnosis and treatment of gastrointestinal cancers. Cancer is treated at a specialized center, which is certified according to the standards of the German Cancer Society (DKG) in the treatment of colon, esophageal, pancreatic, and liver cancer. The department houses a modern Endoscopy Unit (ISO 9001:2000 certification), where doctors perform the full range of diagnostic and therapeutic procedures for stomach, colon, esophageal, gallbladder, bile duct, and liver pathologies. Moreover, there is a well-equipped Laboratory for Functional Diagnostics of the Gastrointestinal Tract and a Center for Ultrasound Diagnostics, where more than 25,000 ultrasound procedures are performed every year. The department provides patients with high-quality medical services using the very latest achievements of university medicine. At the same time, the key role is a humane attitude and understanding of the individual needs and wishes of each patient. The Head Physician of the department is Prof. Dr. med. Thomas Seufferlein.

The department's gastroenterologists, in collaboration with abdominal surgeons, oncologists, radiologists, radiation therapists, and other specialists, provide patients with effective treatment of gastrointestinal cancers using modern therapeutic methods. Doctors most often deal with colon cancer, which is the third most common cancer worldwide. Treatment tactics depend on the stage of cancer. Small tumors in their early stages are removed using endoscopic techniques (colonoscopy) or minimally invasive en bloc resections. The advanced stages of oncology require extensive surgery that involves the resection of the tumor along with a part of the intestine and other affected anatomical structures. A treatment regimen usually includes conservative methods such as chemotherapy, radiation therapy, targeted therapy, immunotherapy, etc. It is important for the department's doctors to provide patients with effective treatment tailored to their individual wishes and needs. Each clinical case is therefore considered during tumor boards, where specialists from related medical fields study the patient's diagnostic results and jointly determine which treatment will provide the best result.

The department has also accumulated vast clinical experience in the treatment of patients with Crohn's disease and ulcerative colitis. At the diagnostic stage, a patient with suspected chronic inflammatory bowel disease undergoes a complex of laboratory tests, imaging examinations (ultrasound, CT, MRI, or PET-CT), and colonoscopy. The first-line treatment for exacerbations of the inflammatory process in the intestine involves an individually prescribed drug therapy regimen, which includes the intake of biological drugs, steroids, aminosalicylates, and other medications. In some cases, infusion therapy with biological drugs may be required. If drug therapy fails, the department's gastroenterologists consider the option of endoscopic treatment. The last-line treatment is surgery, and abdominal surgeons are responsible for its performance.

In the field of hepatology, the focus of doctors is on the diagnostics and treatment of liver diseases. The specialists at the medical facility regularly admit patients with fatty liver disease, cirrhosis, hepatitis, drug-induced liver injury, alpha-1-antitrypsin deficiency, and other pathologies. In most cases, doctors manage to achieve recovery or sustained remission of the disease with the help of a properly selected drug therapy regimen. In some cases, an endoscopic procedure called transjugular intrahepatic portosystemic shunting may be performed to alleviate the condition of a patient with liver disease. This method is most often used to arrest bleeding caused by cirrhosis. The essence of the endoscopic manipulation lies in creating a vascular network to ensure the outflow of blood from the portal vein into the inferior vena cava, bypassing the affected liver tissue.

The department specializes in the diagnostics and treatment of the following diseases:

• Gastroenterology
  • Malignant gastrointestinal diseases
    • Colon cancer
    • Stomach cancer
    • Esophageal cancer
    • Rectal cancer
    • Pancreatic cancer
    • Neuroendocrine gastrointestinal tumors
  • Benign gastrointestinal diseases
    • Stomach and colon polyps
    • Stomach ulcers
    • Chronic inflammatory bowel disease: Crohn's disease and ulcerative colitis
    • Gastroesophageal reflux disease
    • Gastrointestinal bleeding
    • Pancreatitis
• Hepatology
  • Malignant diseases of the liver, gallbladder, and bile ducts
    • Liver cancer
    • Gallbladder cancer
    • Bile duct cancer
  • Benign diseases of the liver, gallbladder, and bile ducts
    • Cirrhosis
    • Fatty liver disease
    • Drug-induced liver injury
    • Autoimmune liver diseases: autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis
    • Storage diseases affecting the liver (for example, hemochromatosis and Wilson's disease)
    • Alpha-1-antitrypsin deficiency
    • Viral hepatitis (acute and chronic viral infections A, B, C, and D)
    • Liver disease in pregnant women
    • Liver lesions caused by rheumatic diseases
• Other diseases

The department's range of medical services includes the following:

• Diagnostic options
  • Endoscopic examinations of the gastrointestinal tract
    • Gastroscopy
    • High-resolution video endoscopy
    • Narrow-band imaging (NBI)
    • Chromoendoscopy
    • Endosonography and endosonography-guided puncture
    • Capsule endoscopy
    • Double-balloon enteroscopy
    • Spiral endoscopy
    • Rectosigmoidoscopy
    • Proctoscopy
    • Endoscopic retrograde cholangiopancreatography
    • Cholangioscopy
  • Ultrasound examinations of the gastrointestinal tract
    • Ultrasound scanning of the upper gastrointestinal tract
    • Elastography
    • Ultrasound-guided punctures
    • Ultrasonographic diagnostics of alveococcosis and echinococcosis
    • Contrast-enhanced ultrasound scanning
  • Functional gastrointestinal diagnostics
    • Esophageal impedance monitoring
    • 24-hour esophageal impedance pH monitoring
    • Lactose hydrogen breath test
    • Fructose hydrogen breath test
    • Glucose hydrogen breath test
• Therapeutic options
  • Balloon dilatation of stenotic gastrointestinal areas followed by stent implantation
  • Endoscopic hemostasis
  • Latex ligation and sclerotherapy for esophageal varices
  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection
  • Polypectomy
  • Foreign body removal from the gastrointestinal organs
  • Percutaneous endoscopic gastrostomy
  • Ablation procedure for Barrett's esophagus (BarrX therapy)
  • Argon plasma coagulation
  • Laser therapy
  • Papillotomy
  • Lithotripsy for bile duct stones
  • Bile and pancreatic duct drainage
  • Transjugular intrahepatic portosystemic shunting
• Other diagnostic and treatment methods