Management of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis—An Evidence-based Consensus Guideline From the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition

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Synopsis

Background and aim
Acute severe colitis (ASC) is one of the few emergencies in pediatric gastroenterology. Tight monitoring and timely medical and surgical interventions may improve outcomes and minimize morbidity and mortality. We aimed to standardize daily treatment of ASC in children through detailed recommendations and practice points which are based on a systematic review of the literature and consensus of experts.

Methods
These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Fifteen predefined questions were addressed by working subgroups. An iterative consensus process, including 2 face-to-face meetings, was followed by voting of the national representatives of ECCO and all members of the PaediatricInflammatory Bowel Disease (IBD) Porto group of ESPGHAN (43 voting experts).

Results
A total of 24 recommendations and 43 practice points were endorsed with a consensus rate of at least 91% regarding diagnosis, monitoring, and management of ASC in children. A summary flowchart is presented based on daily scoring of the Paediatric Ulcerative Colitis Activity Index. Several topics have been altered since the previous 2011 guidelines and from those published in adults.

Discussion
These guidelines standardize the management of ASC in children in an attempt to optimize outcomes of this intensive clinical scenario.

Keywords: acute severe colitis; antibiotics; anti-coagulants; anti-TNF; colectomy; mesalamine; Pediatric Ulcerative Colitis Activity Index; prediction; steroids; ulcerative colitis

Also see part 1 of these guidelines: Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care—An Evidence-based Guideline From European Crohn's and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition

Available Languages

English

Source File

Publishing organization(s):

ECCO European Crohn’s and Colitis Organisation, ESPGHAN European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Scientific area:

IBD, Paediatrics
 

Categorisation:

  • Format
    • Standards and Guidelines
  • Language
    • English
  • UEG Member Society
    • European Crohn’s and Colitis Organisation (ECCO)
    • European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)
  • UEG Week Pathway
    • IBD
    • Paediatrics
  • Year
    • 2018