You are here

  • Home
  • Archive
  • Volume 71, Issue 8
  • 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

Article Text

Article menu
Guidelines
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
  1. Anjan Dhar1,2,
  2. Hasan N Haboubi3,4,
  3. Stephen E Attwood5,
  4. Marcus K H Auth6,7,
  5. Jason M Dunn8,9,
  6. Rami Sweis10,
  7. Danielle Morris11,
  8. Jenny Epstein12,
  9. Marco R Novelli13,
  10. Hannah Hunter14,
  11. Amanda Cordell15,
  12. Sharon Hall16,
  13. Jamal O Hayat17,
  14. Kapil Kapur18,
  15. Andrew Robert Moore19,
  16. Carol Read20,
  17. Sarmed S Sami21,
  18. Paul J Turner22,23,
  19. Nigel J Trudgill24
  1. 1 Gastroenterology, Darlington Memorial Hospital, Darlington, UK
  2. 2 Teesside University, Middlesbrough, UK
  3. 3 Cancer Biomarker Group, Swansea University, Swansea, UK
  4. 4 Department of Gastroenterology, University Hospital Llandough, Llandough, UK
  5. 5 Health Services Research, Durham University, Morpeth, Durham, UK
  6. 6 Department of Paediatric Gastroenterology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  7. 7 University of Liverpool, Liverpool, UK
  8. 8 Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  9. 9 Comprehensive Cancer Centre, King's College London, London, UK
  10. 10 Research Department of Tissue and Energy, Division of Surgery & Interventional Science, University College London, London, UK
  11. 11 Department of Gastroenterology, East and North Hertfordshire NHS Trust, Stevenage, UK
  12. 12 Department of Paediatric Gastroenterology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  13. 13 Histopathology, University College London, London, UK
  14. 14 Department of Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
  15. 15 Trustee & Chair, EOS Network, Eosinophilic Disease Charity, London, UK
  16. 16 Department of Paediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
  17. 17 Gastroenterology, St George's Healthcare NHS Trust, London, UK
  18. 18 Gastroenterology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
  19. 19 Gastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  20. 20 Medical advisor/Patient advocate, EOS Network, Eosinophilic Disease Charity, London, UK
  21. 21 Gastroenterology, University College London Hospitals NHS Foundation Trust, London, UK
  22. 22 National Heart and Lung Institute Section of Allergy and Clinical Immunology, London, UK
  23. 23 Paediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
  24. 24 Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
  1. Correspondence to Professor Anjan Dhar, Gastroenterology, Darlington Memorial Hospital, Darlington DL3 6HX, UK; adhar{at}nhs.net

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.

  • DYSPHAGIA
  • DIET
  • ENDOSCOPY
  • OESOPHAGEAL DISEASE
  • PAEDIATRIC GASTROENTEROLOGY
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/gutjnl-2022-327326

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    Footnotes

    • AD and HNH are joint first authors.

    • Twitter @anjan_dhar6, @LiverpoolAndrew, @CarolLRead

    • Contributors AD, HNH, SEA, NJT undertook the literature search and initial sorting of manuscripts. Subsequent review of manuscripts was undertaken by Core Writing Group leads: AD (Definition and Epidemiology), NJT (Clinical presentation, symptoms and access to care), MRN (Investigations-Histology), RS (Investigations-non-histology), JMD (Treatment), SEA (Complications and Future research), MKHA (Paediatric sections). PICO Statements and guideline statements were developed within these working groups by all members. All members contributed to discussion and voting (organised by HNH). All core writing group leads contributed to manuscript writing within their group with AD and HNH completing all other sections of the manuscript. All other authors fulfil the ICMJE recommendations for authorship with appropriate involvement at all stages of the guideline development process, and drafting of the manuscript. AD and HNH contributed equally to this paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests See Supplementary Table 1.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.