Eosinophilic esophagitis in children and adolescents: a clinical practice guideline

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.