Italian Journal of Pediatrics (Jul 2025)

Eosinophilic esophagitis in children and adolescents: a clinical practice guideline

  • Salvatore Oliva,
  • Serena Arrigo,
  • Matteo Bramuzzo,
  • Fabio Cisarò,
  • Emanuele Dabizzi,
  • Giovanni Di Nardo,
  • Paolo Gandullia,
  • Massimo Martinelli,
  • Maurizio Mennini,
  • Fabio Monica,
  • Lorenzo Norsa,
  • Francesca Rea,
  • Sara Renzo,
  • Claudio Romano,
  • Silvia Salvatore,
  • Edoardo Vincenzo Savarino,
  • Caterina Strisciuglio,
  • Renato Tambucci,
  • Carlo Calabrese,
  • Paola De Angelis,
  • On behalf of The 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)

DOI
https://doi.org/10.1186/s13052-025-02056-x
Journal volume & issue
Vol. 51, no. 1
pp. 1 – 31

Abstract

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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.

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