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. 2022 Aug;71(8):1459-1487.
doi: 10.1136/gutjnl-2022-327326. Epub 2022 May 23.

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

Anjan Dhar  1   2 , Hasan N Haboubi  3   4 , Stephen E Attwood  5 , Marcus K H Auth  6   7 , Jason M Dunn  8   9 , Rami Sweis  10 , Danielle Morris  11 , Jenny Epstein  12 , Marco R Novelli  13 , Hannah Hunter  14 , Amanda Cordell  15 , Sharon Hall  16 , Jamal O Hayat  17 , Kapil Kapur  18 , Andrew Robert Moore  19 , Carol Read  20 , Sarmed S Sami  21 , Paul J Turner  22   23 , Nigel J Trudgill  24
Affiliations

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

Anjan Dhar et al. Gut. 2022 Aug.

Abstract

Background: Eosinophilic oesophagitis (EoE) is an increasingly common cause of dysphagia in both children and adults, as well as one of the most prevalent oesophageal diseases with a significant impact on physical health and quality of life. We have provided a single comprehensive guideline for both paediatric and adult gastroenterologists on current best practice for the evaluation and management of EoE.

Methods: The Oesophageal Section of the British Society of Gastroenterology was commissioned by the Clinical Standards Service Committee to develop these guidelines. The Guideline Development Group included adult and paediatric gastroenterologists, surgeons, dietitians, allergists, pathologists and patient representatives. The Population, Intervention, Comparator and Outcomes process was used to generate questions for a systematic review of the evidence. Published evidence was reviewed and updated to June 2021. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to assess the evidence and make recommendations. Two rounds of voting were held to assess the level of agreement and the strength of recommendations, with 80% consensus required for acceptance.

Results: Fifty-seven statements on EoE presentation, diagnosis, investigation, management and complications were produced with further statements created on areas for future research.

Conclusions: These comprehensive adult and paediatric guidelines of the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition 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.

Keywords: DIET; DYSPHAGIA; ENDOSCOPY; OESOPHAGEAL DISEASE; PAEDIATRIC GASTROENTEROLOGY.

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Conflict of interest statement

Competing interests: See Supplementary Table 1.

Figures

Figure 1
Figure 1
Flow chart of guideline development process. GDG, guideline development group; PICO, Population, Intervention, Comparator, Outcome.
Figure 2
Figure 2
Eosinophilic oesophagitis diagnostic algorithm in emergency and elective settings. EoE, eosinophilic oesophagitis; GORD, gastro-oesophageal reflux disease; PPI, proton pump inhibitor.
Figure 3
Figure 3
Eosinophilic oesophagitis management algorithm in adults and children. PPI, proton pump inhibitor.
Figure 4
Figure 4
Dietary management of eosinophilic oesophagitis in children (grey) and adults. EoE, eosinophilic oesophagitis; PPI, proton pump inhibitor.
See this image and copyright information in PMC

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