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.
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.
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.
Algorithm for dietary management of eosinophilic oesophagitis (EoE) in paediatrics
Histological diagnosis of EoE confirmed by a gastroenterologist.
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.
Assessment and Management of Oesophageal Varices in Children
Joint Guideline of the Children’s Specialised Liver Services at King’s, Birmingham, and Leeds.
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.
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.
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.
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.
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.
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.
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.
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.
Management of Peutz-Jeghers Syndrome in Children and Adolescents: A Position Paper From the ESPGHAN Polyposis Working Group
This position paper provides a guide for diagnosis, assessment, and management of PJS in children and adolescents and guidance on avoiding complications from PJS or from the endoscopic procedures performed on these patients.
Medical Management of Chronic Pancreatitis in Children: A Position Paper by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee
This position paper summarizes the current understanding of the medical management of chronic pancreatitis (CP) in children in light of the existing medical literature, incorporating recent advances in understanding of nutrition, pain, lifestyle considerations, and sequelae of CP.
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the Society for Pediatric Radiology Joint Position Paper on Noninvasive Imaging of Pediatric Pancreatitis: Literature Summary and Recommendations
The reported incidence of pediatric pancreatitis is increasing. Noninvasive imaging, including ultrasound computed tomography (CT), and magnetic resonance imaging (MRI), play important roles in the diagnosis, staging, follow-up, and management of pancreatitis in children.
The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update
We present state-of-the-art guidance on the medical treatment and long-term management of children and adolescents with CD.
European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations
ACG Clinical Guideline: Chronic Pancreatitis
This guideline will provide an evidence-based practical approach to the diagnosis and management of CP for the general gastroenterologist.
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.
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.
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.
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.
Chronic Pancreatitis and Nutrition Therapy
Chronic pancreatitis is a complex and irreversible disease of the pancreas and is associated with significant morbidity and mortality.
Nutrition Management in Acute Pancreatitis
Acute pancreatitis (AP) is one of the most prevalent gastrointestinal conditions necessitating inpatient care.
LSG|UK Steatotic Liver Guideline 2025-26 Version
This guideline has been designed to aid practitioners in how to proceed when imaging studies identify hepatic steatosis (a bright, hyperechoic liver as compared to the spleen on ultrasound) or raised liver enzymes are detected in an overweight child.
Paediatric Acute Liver Failure Protocol
Acute liver failure (ALF) is a potentially life-threatening condition that necessitates early recognition and optimal management and transfer to a Liver Transplant Centre for further management that might include liver transplantation.
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).
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.
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.
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.
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.
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.
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.
Investigation of Neonatal Conjugated Jaundice
This guideline aims to advise clinicians on the initial investigations necessary when an infant with conjugated jaundice is identified.
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.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Standard versus individualized parenteral nutrition
PN can be provided as a standard, usually commercial, formulation that is designed to meet the nutritional needs of most patients of the same age group with a similar condition.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Lipids
The rate, amount, and type of lipids provided intravenously are important aspects regarding the efficacy and safety in neonates and children.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Iron and trace minerals
Iron is an essential nutrient and iron deficiency results in anemia as well as poor neurodevelopment in children.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Fluid and electrolytes
The aim of the current revision is to update the previous chapter on basis of the scientific evidence published since 2004.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Energy
Energy supply needs to meet the nutritional needs of the patient which include basal metabolic rate, physical activity, growth, diet induced thermogenesis and correction of pre-existing malnutrition.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Carbohydrates
Carbohydrates are the main source of energy in nutrition and usually provide 40-60% of the energy supply in western diets.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Calcium, phosphorus and magnesium
In infants and children growth is the major determinant of mineral requirements.
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on paediatric parenteral nutrition: Amino acids
Recommendations were developed from a standpoint of nutrient adequacy. Depending on age groups, nutrient adequacy was based on intrauterine accretion rate, organ development, factorial estimates of requirements and amino acid interactions. Individual amino acids are discussed.
Recommendations for Nutritional Management of Children with Neurological Impairment (NI)
This guide provides recommendations and a systematic approach for the care of paediatric patients with NI.
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