Training in pediatric neurogastroenterology and motility across Europe: a survey of the ESPGHAN National Societies Network 2016-2019

Alexandra Papadopoulou; Carmen Ribes-Koninckx; Alastair Baker; Maria Noni; Eleni Koutri; Maria-Vasiliki Karagianni; Sue Protheroe; Alfredo Guarino; Emmanuel Mas; Michael Wilschanski; Enriqueta Roman; Johanna Escher; Raoul I Furlano; Carsten Posovszky; Ilse Hoffman; Gabor Veres; Jiri Bronsky; Almuthe Christine Hauer; Duska Tjesic-Drinkovic; Maria Fotoulaki; Rok Orel; Vaidotas Urbonas; Aydan Kansu; Miglena Georgieva; Marc Benninga; Nikhil Thapar

doi:10.20524/aog.2022.0710

Training in pediatric neurogastroenterology and motility across Europe: a survey of the ESPGHAN National Societies Network 2016-2019

Ann Gastroenterol. 2022 May-Jun;35(3):325-332. doi: 10.20524/aog.2022.0710. Epub 2022 Apr 7.

Authors

Alexandra Papadopoulou¹, Carmen Ribes-Koninckx², Alastair Baker³, Maria Noni¹, Eleni Koutri¹, Maria-Vasiliki Karagianni¹, Sue Protheroe⁴, Alfredo Guarino⁵, Emmanuel Mas⁶, Michael Wilschanski⁷, Enriqueta Roman⁸, Johanna Escher⁹, Raoul I Furlano¹⁰, Carsten Posovszky¹¹, Ilse Hoffman¹², Gabor Veres¹³, Jiri Bronsky¹⁴, Almuthe Christine Hauer¹⁵, Duska Tjesic-Drinkovic¹⁶, Maria Fotoulaki¹⁷, Rok Orel¹⁸, Vaidotas Urbonas¹⁹, Aydan Kansu²⁰, Miglena Georgieva²¹, Marc Benninga²², Nikhil Thapar²³

Affiliations

¹ Division of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Agia Sofia Children's Hospital, Athens, Greece (Alexandra Papadopoulou, Maria Noni, Eleni Koutri, Maria-Vasiliki Karagianni).
² Pediatric Gastroenterology Unit, La Fe University Hospital, Valencia, Spain (Carmen Ribes-Koninckx).
³ Pediatric Liver Centre, King's College Hospital, London, United Kingdom (Alastair Baker).
⁴ Birmingham Children's Hospital, NHS Foundation Trust, Birmingham, United Kingdom (Sue Protheroe).
⁵ Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy (Alfredo Guarino).
⁶ Unit of Gastroenterology, Hepatology, Nutrition, Diabetes, and Inborn Errors of Metabolism, Children Hospital, Toulouse University Hospital, Toulouse, France (Emmanuel Mas).
⁷ Pediatric Gastroenterology Unit, Department of Pediatrics, Hadassah University Hospitals, Jerusalem, Israel (Michael Wilschanski).
⁸ Pediatric Gastroenterology Unit, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain (Enriqueta Roman).
⁹ Department of Pediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands (Johanna Escher).
¹⁰ Division of Pediatric Gastroenterology and Nutrition, University Children's Hospital, Basel, Switzerland (Raoul I. Furlano).
¹¹ Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany (Carsten Posovszky).
¹² Department of Pediatric Gastroenterology, Leuven University Hospital, Leuven, Belgium (Ilse Hoffman).
¹³ Pediatric Institute-Clinic, University of Debrecen, Debrecen, Hungary (Gabor Veres).
¹⁴ Department of Pediatrics, University Hospital Motol, Prague, Czech Republic (Jiri Bronsky).
¹⁵ Department of Pediatrics, Medical University of Graz, Graz, Austria (Almuthe Christine Hauer).
¹⁶ University Hospital Center Zagreb - Division for Pediatric Gastroenterology, Hepatology and Nutrition & University of Zagreb School of Medicine, Zagreb, Croatia (Duska Tjesic-Drinkovic).
¹⁷ 4 Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece (Maria Fotoulaki).
¹⁸ Department of Gastroenterology, Hepatology and Nutrition, Ljubljana University Children's Hospital, Ljubljana, Slovenia (Rok Orel).
¹⁹ Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania (Vaidotas Urbonas).
²⁰ Division of Pediatric Gastroenterology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey (Aydan Kansu).
²¹ 2 Department of Pediatrics, Saint Marina University hospital, Varna, Bulgaria (Miglena Georgieva).
²² Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands (Marc Benninga).
²³ Gastroenterology Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom (Nikhil Thapar).

Abstract

Background: Pediatric gastrointestinal motility disorders present significant challenges for diagnosis and management, emphasizing the need for appropriate training in Pediatric Neurogastroenterology and Motility (PNGM). The aim of this survey, part of a comprehensive survey on training in pediatric gastroenterology, hepatology and nutrition, was to evaluate training related to PNGM across European training centers.

Method: Standardized questionnaires were collected from training centers through the National Societies Network of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), from June 2016 to December 2019.

Results: In total, 100 training centers from 19 countries participated in the survey. Dedicated PNGM clinics were available in 22 centers; pH-monitoring in 60; pH/impedance in 66; standard manometry in 37; and high-resolution manometry in 33. If all motility studies were performed partially or fully by the trainees, the median (range) annual numbers/per trainee were as follows: pH-monitoring 30 (1-500); pH/impedance 17 (1-131); standard manometries 10 (1-150); and high-resolution manometries 8 (1-75). The motility assessment was performed by pediatric gastroenterologists (43 centers); adult gastroenterologists (10 centers); pediatric surgeons (5 centers); and both pediatric gastroenterologists and pediatric surgeons (9 centers). Annual numbers ≤10 for pH-monitoring, pH/impedance, standard manometries and high-resolution manometries were reported by 7 (12%), 15 (23%), 11 (30%) and 14 (42%) centers, respectively.

Conclusions: Significant differences exist in PNGM-related infrastructure, staff and procedural volumes at training centers across Europe. ESPGHAN and the National Societies should take initiatives to ensure the acquisition of competence in PNGM-related knowledge and skills, and develop strategies for assessment and accreditation.An infographic is available for this article at: http://www.annalsgastro.gr/files/journals/1/earlyview/2022/Infographic-AG6486.pdf.

Keywords: Gastrointestinal motility training; children; hepatology and nutrition; training in pediatric gastroenterology.