Guidelines

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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
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
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
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
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
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
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
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
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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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Guidelines for the diagnosis and management of pancreatitis in children
Pancreatitis

Guidelines for the diagnosis and management of pancreatitis in children

This guideline covers the diagnosis and management of acute and chronic pancreatitis in children and young people (CYP) in the United Kingdom

Published: January 2024
Intestinal Ultrasound for the Pediatric Gastroenterologist: A Guide for Inflammatory Bowel Disease Monitoring in Children
Clinical PracticeEvidence-basedIBD

Intestinal Ultrasound for the Pediatric Gastroenterologist: A Guide for Inflammatory Bowel Disease Monitoring in Children

Expert Consensus on Behalf of the International Bowel Ultrasound Group (IBUS) Pediatric Committee.

Published: February 2023
AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Ulcerative Colitis
Clinical PracticeEvidence-basedUlcerative Colitis

AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Ulcerative Colitis

Published: January 2023
Genomic diagnosis and care co-ordination for monogenic inflammatory bowel disease in children and adults: consensus guideline on behalf of the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition
BSGIBDLimited Scientific EvidencePosition Paper

Genomic diagnosis and care co-ordination for monogenic inflammatory bowel disease in children and adults: consensus guideline on behalf of the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition

This joint British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition guideline aims to ensure that testing resources are appropriately applied to maximise the benefit to patients on a national scale, minimise health-care disparities in accessing genomic technologies, and optimise resource use.

Published: January 2023
The management of complications associated with IgA vasculitis (Henoch Schönlein Purpura) in children and young people
Clinical PracticeEvidence-based

The management of complications associated with IgA vasculitis (Henoch Schönlein Purpura) in children and young people

UK Kidney Association Clinical Practice Guidelines for the Initial Management of IgA vasculitis (Henoch Schönlein Purpura) in children and young people.

Published: December 2022
The initial management of IgA vasculitis (Henoch Schönlein Purpura) in children and young people
Clinical PracticeEvidence-based

The initial management of IgA vasculitis (Henoch Schönlein Purpura) in children and young people

A complimentary document on the best practice guidelines for the complications associated with IgAV in children and young people.

Published: December 2022
Acute Pancreatitis: Diagnosis and Treatment
Acute PancreatitisLimited Scientific EvidencePosition Paper

Acute Pancreatitis: Diagnosis and Treatment

Acute pancreatitis is a common indication for hospital admission, increasing in incidence, including in children, pregnancy and the elderly.

Published: September 2022
ESPGHAN Position Paper on Management and Follow up of Children and Adolescents With Celiac Disease
ESPGHANLimited Scientific EvidencePosition Paper

ESPGHAN Position Paper on Management and Follow up of Children and Adolescents With Celiac Disease

Recommendations to improve follow-up of children and adolescents with celiac disease and highlight gaps that should be investigated to further improve management.

Published: September 2022
British Society of Gastroenterology guidelines on the management of functional dyspepsia
BSGFunctional DyspepsiaLimited Scientific EvidencePosition Paper

British Society of Gastroenterology guidelines on the management of functional dyspepsia

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 diagnosis and treatment of patients.

Published: July 2022
ACG Clinical Guideline: Gastroparesis
ACG Clinical GuidelinesClinical PracticeEvidence-basedGastroparesis

ACG Clinical Guideline: Gastroparesis

These guidelines summarize perspectives on the risk factors, diagnosis, and management of gastroparesis in adults (including dietary, pharmacological, device, and interventions directed at the pylorus), and they represent the official practice recommendations of the American College of Gastroenterology.

Published: June 2022
Colonic Function Investigations in Children: Review by the ESPGHAN Motility Working Group
ESPGHANLimited Scientific EvidencePosition Paper

Colonic Function Investigations in Children: Review by the ESPGHAN Motility Working Group

This review is a practical guide, which highlights the recent advances in paediatric colonic motility testing including indications, technical principles of the tests, patient preparation, performance and basis of the results’ analysis of the tests.

Published: May 2022
The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee
ESPGHANLimited Scientific EvidencePosition Paper

The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee

Summary of the current paediatric and adult literature and provide recommendations for the surgical management of CP in children.

Published: May 2022
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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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