Guidelines

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ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth
ACG Clinical GuidelinesClinical PracticeEvidence-based

ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth

This guideline statement evaluates criteria for diagnosis, defines the optimal methods for diagnostic testing, and summarizes treatment options for small intestinal bacterial overgrowth.

Published: January 2020
BSPGHAN Motility Working Group consensus statement- Anorectal manometry in children with defecation disorders
Limited Scientific EvidenceMotilityPosition Paper

BSPGHAN Motility Working Group consensus statement- Anorectal manometry in children with defecation disorders

Guidance on the use of ARM/HRAM in children with CC and/or FI.

Published: January 2020
ESPGHAN New Guidelines for the Diagnosis of Paediatric Coeliac Disease
Coeliac DiseaseESPGHAN

ESPGHAN New Guidelines for the Diagnosis of Paediatric Coeliac Disease

This advice guide provides new and updated summary guidance from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) on diagnosing children and adolescents with CD.

Published: January 2020
ESPGHAN Guidelines for Diagnosing Coeliac Disease
Coeliac DiseaseESPGHAN

ESPGHAN Guidelines for Diagnosing Coeliac Disease

The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases. Here, an updated and expanded evidence-based guideline is presented.

Published: January 2020
Nutrition Management in Acute Pancreatitis
Review

Nutrition Management in Acute Pancreatitis

Acute pancreatitis (AP) is one of the most prevalent gastrointestinal conditions necessitating inpatient care.

Published: September 2019
Management of Exocrine Pancreatic Insufficiency in Children
Review

Management of Exocrine Pancreatic Insufficiency in Children

The diagnosis of exocrine pancreatic insufficiency (EPI) can be difficult, as symptoms may be nonspecific.

Published: September 2019
Chronic Pancreatitis and Nutrition Therapy
Review

Chronic Pancreatitis and Nutrition Therapy

Chronic pancreatitis is a complex and irreversible disease of the pancreas and is associated with significant morbidity and mortality.

Published: September 2019
Practical guide to the management of acute pancreatitis
Acute PancreatitisLimited Scientific EvidencePosition Paper

Practical guide to the management of acute pancreatitis

Position paper discussing current diagnostic and management challenges and addressing the common dilemmas in AP.

Published: March 2019
2019 WSES guidelines for the management of severe acute pancreatitis
Acute PancreatitisLimited Scientific EvidencePosition Paper

2019 WSES guidelines for the management of severe acute pancreatitis

The main topics of these guidelines fall under the following topics: Diagnosis, Antibiotic treatment, Management in the Intensive Care Unit, Surgical and operative management, and Open abdomen.

Published: January 2019
Part 1: Ambulatory Care – An Evidence-based Guideline From European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition
Limited Scientific EvidencePaediatric Ulcerative ColitisPosition Paper

Part 1: Ambulatory Care – An Evidence-based Guideline From European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition

These guidelines provide a guide to clinicians managing children with UC and IBD-unclassified management to provide modern management strategies while maintaining vigilance around appropriate outcomes and safety issues.

Published: August 2018
Part 2: Acute Severe Colitis – An Evidence-based Consensus Guideline From the European Crohn’s and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition
Limited Scientific EvidencePaediatric Ulcerative ColitisPosition Paper

Part 2: Acute Severe Colitis – An Evidence-based Consensus Guideline From the European Crohn’s and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition

These guidelines standardize the management of ASC in children in an attempt to optimize outcomes of this intensive clinical scenario.

Published: August 2018
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Complications
CSPENESPENESPGHANESPREvidence-based

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Complications

The search was conducted in Ovid Medline using both MeSH terms and text words for “parenteral nutrition complications”. In parallel an expert search was conducted focusing on specific subtopics of parenteral nutrition complications.

Published: June 2018
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Assessment, monitoring and management of deliberate and accidental paracetamol overdose in Children
Paracetamol Overdose

Assessment, monitoring and management of deliberate and accidental paracetamol overdose in Children

Joint Guideline proposed by the Children’s Specialised Liver Services at King’s, Birmingham, and Leeds.

Published: March 2024
BSG Position Paper: Green Endoscopy
EndoscopyPosition PaperSustainable Health

BSG Position Paper: Green Endoscopy

Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG) and Centre for Sustainable Health (CSH) joint consensus on practical measures for environmental sustainability in endoscopy.

Published: September 2022
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British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults
EoELimited Scientific EvidencePosition Paper

British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults

These comprehensive adult and paediatric guidelines are based on evidence and expert consensus from a multidisciplinary group of healthcare professionals, including patient advocates and patient support groups, to help clinicians with the management patients with EoE and its complications.

Published: May 2022
An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology
ESPGHANLimited Scientific EvidencePosition Paper

An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Given a lack of a systematic approach to the use of breath testing in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimise its utility and safety.

Published: January 2022
Drugs in Focus: Octreotide Use in Children With Gastrointestinal Disorders
ESPGHANLimited Scientific EvidencePosition Paper

Drugs in Focus: Octreotide Use in Children With Gastrointestinal Disorders

The aim of this paper is to provide information regarding the use, mode of delivery and safety of this agent in different GI disorders.

Published: January 2022
Algorithm for dietary management of eosinophilic oesophagitis (EoE) in paediatrics
EoELimited Scientific EvidencePosition Paper

Algorithm for dietary management of eosinophilic oesophagitis (EoE) in paediatrics

Histological diagnosis of EoE confirmed by a gastroenterologist.

Published: November 2021
Percutaneous Endoscopic Gastrostomy in Children: An Update to the ESPGHAN Position Paper
ESPGHANLimited Scientific EvidencePosition Paper

Percutaneous Endoscopic Gastrostomy in Children: An Update to the ESPGHAN Position Paper

The aim of this position paper is to update all relevant information regarding gastrostomies in paediatric patients published since 2014.

Published: September 2021
Assessment and Management of Oesophageal Varices in Children
EndoscopyLimited Scientific EvidencePosition Paper

Assessment and Management of Oesophageal Varices in Children

Joint Guideline of the Children’s Specialised Liver Services at King’s, Birmingham, and Leeds.

Published: September 2021
Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper
ESPGHANLimited Scientific EvidencePosition Paper

Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper

As one of the first initiatives of the ESPGHAN task force, this ESPGHAN position paper has been written. The literature is summarized, and prevention strategies are discussed focusing on some controversial topics.

Published: July 2021
Electrogastrography Abnormalities in Pediatric Gastroduodenal Disorders: A Systematic Review and Meta-analysis
ElectrogastrographyLimited Scientific EvidencePosition Paper

Electrogastrography Abnormalities in Pediatric Gastroduodenal Disorders: A Systematic Review and Meta-analysis

This study aimed to quantify the abnormalities in gastric electrophysiology on EGG in neonatal and pediatric patients.

Published: July 2021
Genetic Enteropathies Linked to Epithelial Structural Abnormalities and Enteroendocrine Deficiency: A Systematic Review
Clinical PracticeEvidence-basedGenetic Enteropathies

Genetic Enteropathies Linked to Epithelial Structural Abnormalities and Enteroendocrine Deficiency: A Systematic Review

This review presents data from 323 patients with congenital diarrhea linked to EPCAM TE, SPINT2 TE, TTC37 THE, SKIV2L THE, MYO5B MVID, STX3 MVID, NEUROG3 ED, and PCSK1 ED mutations.

Published: June 2021
World Gastroenterology Organisation Global Guidelines: Helicobacter Pylori
Helicobacter PyloriReview

World Gastroenterology Organisation Global Guidelines: Helicobacter Pylori

Helicobacter pylori continues to be a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer.

Published: May 2021
Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines
Clinical PracticeEvidence-basedPancreatic Exocrine Insufficiency

Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines

Recommendations for clinical practice in the diagnosis, initial management, patient education and long term follow up were developed. All recommendations achieved over 85% consensus and are included within these comprehensive guidelines.

Published: May 2021
British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
BSGIBSLimited Scientific EvidencePosition Paper

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients.

Published: April 2021
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Acute Liver Failure Guidelines by the The American College of Gastroenterology
Liver Failure

Acute Liver Failure Guidelines by the The American College of Gastroenterology

Acute liver failure (ALF) is a life-threatening condition that occurs in patients with no preexisting liver disease and is characterized by liver injury (abnormal liver tests), coagulopathy (international normalized ratio [INR] .1.5), and hepatic encephalopathy (HE).

Published: March 2023
Proposed Prolonged Jaundice Pathway following national audit 2022-2023
Jaundice

Proposed Prolonged Jaundice Pathway following national audit 2022-2023

UK Multi-center practice and adaptation of Guidelines from NICE and Liver centre conjugated hyperbilirubinemia pathway.

Published: January 2023
AGA Clinical Practice Update on Diagnosis and Management of Acute Hepatic Porphyrias: Expert Review
Acute Hepatic Porphyrias

AGA Clinical Practice Update on Diagnosis and Management of Acute Hepatic Porphyrias: Expert Review

The acute hepatic porphyrias (AHP) are rare, inborn errors of heme-metabolism and include acute intermittent porphyria, hereditary coproporphyria, variegate porphyria, and porphyria due to severe deficiency of 5-aminolevulinic acid dehydratase.

Published: January 2023
Early investigation and management of children with acute non-A-E hepatitis, with and without liver failure
Hepatitis

Early investigation and management of children with acute non-A-E hepatitis, with and without liver failure

This clinical framework is intended to provide a structure for the investigation, transfer and management of children with novel non-A-E acute hepatitis in the context of an emergence of a novel disease. The recommendations within this guidance are based on existing principles of management of acute hepatitis and acute liver failure and on expert consensus opinion in the absence of high quality evidence around this novel condition.

Published: May 2022
Assessment and Management of Oesophageal Varices in Children 
Oesophageal Varices

Assessment and Management of Oesophageal Varices in Children 

These guidelines were constructed after a joint audit and review of practice at the three specialised centres in June 2016 and reviewed again in 2021. Although evidence based where possible, where not available they represent consensus. A detailed version of this guideline which includes review of evidence, together with reference to adult evidenced based guidelines is available. Section 4: management of acute variceal bleed: is designed for implementation at any hospital to which a child presents and can be used as a stand-alone guideline.

Published: September 2021
UK Fatty Liver Guidelines
NAFLD

UK Fatty Liver Guidelines

These guidelines were constructed after a joint audit and review at the three specialised paediatric hepatology centres.

Published: August 2020
Updated shielding guidance for children with chronic liver disease and those on immunosuppression (autoimmune and liver transplantation
Chronic Liver DiseaseCOVID-19

Updated shielding guidance for children with chronic liver disease and those on immunosuppression (autoimmune and liver transplantation

In view of the continuous evidence and increasing knowledge in the COVID-19 pandemic we have undertaken an update on the advice to children and families with chronic liver disease.

Published: July 2020
NICE and ESPGHAN Guidelines
ESPGHANNICE

NICE and ESPGHAN Guidelines

These guidelines and standards have been published by NICE and ESPGHAN and are available for information. However, please do not hesitate to contact your local Paediatric Hepatology Team to discuss management of a child with any liver disorder.

Published: June 2017
Investigation of Neonatal Conjugated Jaundice
Jaundice

Investigation of Neonatal Conjugated Jaundice

This guideline aims to advise clinicians on the initial investigations necessary when an infant with conjugated jaundice is identified.

Published: December 2016
Investigation and treatment of liver disease with acute onset
Liver Disease

Investigation and treatment of liver disease with acute onset

 Defined as EITHER sudden onset of jaundice with evidence of liver aetiology OR incidental discovery of raised transaminases in association with symptoms suggesting acute onset.

Published: July 2013
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ESPEN guideline on Clinical Nutrition in inflammatory bowel disease
ESPENEvidence-basedIBD

ESPEN guideline on Clinical Nutrition in inflammatory bowel disease

The guideline is aimed at professionals working in clinical practice, either in hospitals or in outpatient medicine, and treating patients with IBD. General aspects of care in patients with IBD, and specific aspects during active disease and in remission are addressed.

Published: December 2022
Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts
ESPGHANLimited Scientific EvidencePosition Paper

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.

Published: October 2022
The Use of Blended Diets in Children With Enteral Feeding Tubes: A Joint Position Paper of the ESPGHAN Committees of Allied Health Professionals and Nutrition
ESPGHANLimited Scientific EvidencePosition Paper

The Use of Blended Diets in Children With Enteral Feeding Tubes: A Joint Position Paper of the ESPGHAN Committees of Allied Health Professionals and Nutrition

There is little evidence published to formally inform about the potential health benefits or risks of this practice and how to use it in the best way.

Published: August 2022
Synbiotics in the Management of Paediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications
ESPGHANLimited Scientific EvidencePosition Paper

Synbiotics in the Management of Paediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications

There is a need for more, well-designed RCTs on the role of synbiotics in gastrointestinal disorders with the same outcome measures to enable the inter-studies comparisons.

Published: June 2022
ASPEN lipid injectable emulsion safety recommendations part 2: Neonate and paediatric considerations
ASPENLimited Scientific EvidencePosition Paper

ASPEN lipid injectable emulsion safety recommendations part 2: Neonate and paediatric considerations

This paper describes safe-use considerations for ILE products available in the United States in neonatal and paediatric patients, including indications, prescribing, order review, preparation, administration, and monitoring.

Published: October 2021
Parenteral Nutrition for Critically Ill Term and Preterm Neonates: A Commentary on the 2021 European Society for Paediatric Gastroenterology, Hepatology and Nutrition Position Paper
ESPGHANLimited Scientific EvidencePosition Paper

Parenteral Nutrition for Critically Ill Term and Preterm Neonates: A Commentary on the 2021 European Society for Paediatric Gastroenterology, Hepatology and Nutrition Position Paper

Most paediatric societies provide nutritional recommendations for preterm infants (1–6), although these do usually not specifically address requirements during additional intermittent critical illness apart from prematurity, such as necrotizing enterocolitis or fulminant sepsis.

Published: May 2021
Nutritional Management of the Critically Ill Neonate: A Position Paper of the ESPGHAN Committee on Nutrition
ESPGHANLimited Scientific EvidencePosition Paper

Nutritional Management of the Critically Ill Neonate: A Position Paper of the ESPGHAN Committee on Nutrition

Basic research along with adequately powered trials are urgently needed to resolve key uncertainties on metabolism and nutrient requirements in this heterogeneous patient population.

Published: February 2021
Management of Central Venous Access in Children With Intestinal Failure: A Position Paper From the NASPGHAN Intestinal Rehabilitation Special Interest Group
Intestinal FailureLimited Scientific EvidenceNASPGHANPosition Paper

Management of Central Venous Access in Children With Intestinal Failure: A Position Paper From the NASPGHAN Intestinal Rehabilitation Special Interest Group

Pediatric intestinal failure (IF) is characterized by the inability of the gastrointestinal tract to absorb for long-term parenteral nutrition (PN) delivered via a central venous catheter (CVC).

Published: November 2020
North American Society for Paediatric Gastroenterology, Hepatology, and Nutrition Position Paper: Plant-based Milks
Limited Scientific EvidenceNASPGHANPosition Paper

North American Society for Paediatric Gastroenterology, Hepatology, and Nutrition Position Paper: Plant-based Milks

This Position Paper has its origins in a NASPGHAN response to a September 18, 2018 FDA Federal Register Request for Comment regarding the ‘‘Use of the Names of Dairy Foods in the Labeling of Plant-Based Products’’

Published: March 2020
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Complications
CSPENESPENESPGHANESPREvidence-based

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Complications

The search was conducted in Ovid Medline using both MeSH terms and text words for “parenteral nutrition complications”. In parallel an expert search was conducted focusing on specific subtopics of parenteral nutrition complications.

Published: June 2018
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Venous access
CSPENESPENESPGHANESPREvidence-based

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Venous access

Securing reliable venous access is of paramount importance when considering parenteral nutrition (PN).

Published: May 2018
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Vitamins
CSPENESPENESPGHANESPREvidence-based

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Vitamins

A sufficient supply of vitamins is essential for growth and development.

Published: May 2018
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