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Practice Guideline
. 2025 Jul 23;51(1):242.
doi: 10.1186/s13052-025-02056-x.

Eosinophilic esophagitis in children and adolescents: a clinical practice guideline

Salvatore Oliva  1 , Serena Arrigo  2 , Matteo Bramuzzo  3 , Fabio Cisarò  4 , Emanuele Dabizzi  5 , Giovanni Di Nardo  6 , Paolo Gandullia  2 , Massimo Martinelli  7 , Maurizio Mennini  6 , Fabio Monica  8 , Lorenzo Norsa  9 , Francesca Rea  10 , Sara Renzo  11 , Claudio Romano  12 , Silvia Salvatore  13 , Edoardo Vincenzo Savarino  14 , Caterina Strisciuglio  15 , Renato Tambucci  10 , Carlo Calabrese  16 , Paola De Angelis  10 ; Italian Society of Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO), The Italian Society of Gastroenterology (SIGE), and The Italian Society of Digestive Endoscopy (SIED)
Collaborators, Affiliations
Practice Guideline

Eosinophilic esophagitis in children and adolescents: a clinical practice guideline

Salvatore Oliva et al. Ital J Pediatr. .

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition that affects the esophagus and is marked by the presence of eosinophils. This disease is becoming more common in children and adolescents and can result in symptoms like swallowing difficulties, food impaction and abdominal pain. Managing pediatric EoE requires a team effort including gastroenterologists, allergists and dietitians. Medical treatments may include topical corticosteroids, proton pump inhibitors, and elimination diets. Endoscopy plays a key role in the diagnosis, management and monitoring of the condition. The management of pediatric EoE is distinct from that of adult EoE, due to differences in anatomy, physiology and treatment options. Thus, it is recommended that children with EoE see a pediatric gastroenterologist when possible. However, adult gastroenterologists can also contribute to the management of pediatric EoE when a pediatric gastroenterologist is not accessible. A guideline for the management of pediatric EoE in Italy has been created by Italian Society of Gastroenterology, Hepatology and Nutrition (SIGENP) to encourage collaboration between adult gastroenterologists and pediatricians, and it has been endorsed by major adult gastroenterology Italian societies including AIGO, SIGE and SIED, highlighting the importance of collaboration in the diagnosis and management of pediatric EoE.

Keywords: Children; Diet; Dysphagia; EoE; Eosinophilic esophagitis; Food impaction; Guidelines; PPI; Pediatric endoscopy; Topical steroids.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All authors have agreed on the content of this manuscript. Competing interests: None to declare.

Figures

Fig. 1
Fig. 1
Diagnostic Algorithm for Pediatric EoE. Stepwise approach to diagnosing EoE, including symptom assessment, endoscopy with biopsies, and exclusion of alternative causes
Fig. 2
Fig. 2
Therapeutic Pyramid for Pediatric EoE. Hierarchical treatment strategy from first-line options (PPIs, diet) to advanced therapies (biologics, dilation), based on disease severity and phenotype
See this image and copyright information in PMC

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