UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

Not sure what you can access? Learn more about account types.

Abstract

Introduction

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by symptoms of esophageal dysfunction and histologically by predominantly eosinophilic infiltration of the squamous epithelium. European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published a guideline in 2014; however, the rapid evolution of knowledge about pathophysiology, diagnostic criteria, and therapeutic options have made an update necessary.

Methods

A consensus group of pediatric gastroenterologists from the ESPGHAN Working Group on Eosinophilic Gastrointestinal Diseases (ESPGHAN EGID WG) reviewed the recent literature and proposed statements and recommendations on 28 relevant questions about EoE. A comprehensive electronic literature search was performed in MEDLINE, EMBASE, and Cochrane databases from 2014 to 2022. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of evidence and formulate recommendations.

Results

A total of 52 statements based on the available evidence and 44 consensus-based recommendations are available. A revision of the diagnostic protocol, options for initial drug treatment, and the new concept of simplified empiric elimination diets are now available. Biologics are becoming a part of the potential armamentarium for refractory EoE, and systemic steroids may be considered as the initial treatment for esophageal strictures before esophageal dilation. The importance and assessment of quality of life and a planned transition to adult medical care are new areas addressed in this guideline.

Conclusion

Research in recent years has led to a better understanding of childhood EoE. This guideline incorporates the new findings and provides a practical guide for clinicians treating children diagnosed with EoE.

Diagnosis and management of eosinophilic esophagitis in children: An update from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

Jorge Amil Dias

Publisher

European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Guideline

Clinical Practice Guideline

Topics

Oesophagus Paediatrics

Citation

J Pediatr Gastroenterol Nutr. 2024; 79: 394-437

Published

2024

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Summary

Extrahepatic abdominal surgery in patients with cirrhosis of the liver represents a growing clinical challenge due to the increasing prevalence of chronic liver disease and improved long-term survival of these patients. The presence of cirrhosis significantly increases the risk of perioperative morbidity and mortality following abdominal surgery. Advances in preoperative risk stratification, surgical techniques, and perioperative care have led to better outcomes, yet integration of these improvements into routine clinical practice is needed. These clinical practice guidelines provide comprehensive recommendations for the assessment and perioperative management of patients with cirrhosis undergoing extrahepatic abdominal surgery. An individualised patient-centred risk assessment by a multidisciplinary team including hepatologists, surgeons, anaesthesiologists, and other support teams is essential.

EASL Clinical Practice Guidelines on extrahepatic abdominal surgery in patients with cirrhosis and advanced chronic liver disease

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary Surgery

Citation

Journal of Hepatology; 2025

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Summary

Vascular diseases of the liver include portal vein thrombosis (with or without cirrhosis), portosinusoidal vascular disorder, Budd-Chiari syndrome, sinusoidal obstruction syndrome, non-obstructive sinusoidal dilatation and peliosis, splanchnic artery aneurysms, and hepatic arteriovenous fistulas. Except for portal vein thrombosis in cirrhosis, these are all rare conditions. Since the last Clinical Practice Guidelines were issued by the European Association for the Study of the Liver in 2016, much data has been published on the diagnosis and management – medical and interventional – of patients with vascular liver diseases. Based on a thorough review of the relevant literature, recommendations are provided to address key clinical dilemmas. The document emphasises personalised care, considering individual risk factors and clinical presentation. Multidisciplinary management involving hepatologists, haematologists, pathologists, interventional radiologists and surgeons is essential in this area. Our aim is to provide guidance on the management of patients with vascular liver diseases based on the best available evidence.

EASL Clinical Practice Guidelines on vascular diseases of the liver

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary

Citation

Journal of Hepatology; Volume 84, Issue 2, 399-456

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Introduction

Pilonidal disease (PD) is a benign condition affecting the natal cleft in young men and women usually between the ages of 20 and 40 years. Despite an increasing incidence, there is no widely accepted consensus that standardizes the management of this disease. This guideline may act as a resource for patients wanting to gain a comprehensive overview of treatment options. However, primarily, the goal of these guidelines is to provide an internationally collaborated set of recommendations for clinicians and healthcare professionals who treat patients with PD.

European Society of Coloproctology guidelines for the management of pilonidal disease

Dotun Ojo, Gaetano Gallo

Publisher

European Society for Coloproctology

Guideline

Clinical Practice Guideline

Topics

Surgery Colorectal

Citation

BJS, Volume 111, Issue 10, October 2024, znae237

Published

2024

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Summary

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established procedure for managing complications of portal hypertension. In recent years, the field of TIPS has seen rapid advances, particularly in technical approaches, prognostic modelling, and an expanding range of indications. The aim of these EASL guidelines is to comprehensively address all aspects of TIPS in patients with cirrhosis. Other related topics, such as the use of TIPS in surgical settings and in vascular liver disorders, are covered in separate dedicated clinical practice guidelines.

EASL Clinical Practice Guidelines on TIPS

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary

Citation

Journal of Hepatology, Volume 83, Issue 1, 177 - 210

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

ABSTRACT

Importance

The lack of multidisciplinary workflow guidelines and clear definitions and classifications for neoplasms in and around the ampulla of Vater results in inconsistencies affecting patient care and research.

Objective

The PERIPAN international multidisciplinary consensus group aimed to standardize the multidisciplinary diagnostic workflow and achieve consensus on definitions and classifications in order to ensure proper classification and optimal diagnostic assessment and consequently to improve patient care and future research.

Design

An international team of 43 experts (pathologists, surgeons, radiologists, gastroenterologists, oncologists) from 12 countries identified knowledge gaps, reviewed 37061 articles, and proposed recommendations using the Scottish Intercollegiate Guidelines Network methodology (SIGN), including the Delphi methodology and the AGREEII tool for quality assessment and external validation.

Results

The 38 consensus questions and 51 recommendations provide guidance on the following key aspects: I. More specific anatomic criteria for the definition of what qualifies as “ampullary” neoplasms, their distinction from duodenal and common bile duct tumors, and clinicopathologic characteristics of anatomic subsets; II. Avoidance of the confusing term “periampullary” for final classification; III. Refined definitions of intestinal, pancreatobiliary and mixed subtypes, and introduction of rare histologic subtypes; IV. The use and limitations of immunohistochemical and molecular profiling; V. Biopsy acquisition; VI. Clinical information required for accurate pathology assessment of biopsies and ampullectomy specimens; VII. Key items to be included in pathology reports of endoscopic specimens.

Conclusions and Relevance

Recognition of the Brescia PERIPAN guidelines will allow a more accurate classification of true ampullary cancers and their differentiation from other “periampullary” tumors. This will have significant implications for endoscopic interpretation and management, staging, pathologic diagnosis and therapeutic evaluation as well as oncologic treatment of various anatomic and histologic subsets of ampullary tumors. This will enhance the quality of both clinical care and future research in this complex medical field.

The Brescia International Multidisciplinary Consensus Guidelines on the Optimal Pathology Assessment and Multidisciplinary Pathways of Non-Pancreatic Neoplasms in and Around the Ampulla of Vater (PERIPAN)

Mohammad Abu Hilal

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology

Citation

United European Gastroenterology Journal: 1–21.

Published

2025

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

LITERATURE-BASED HELICOBACTER PYLORI RESISTANCE DATA INTEGRATED INTO THE EUROPEAN REGISTRY ON H. PYLORI MANAGEMENT (HP-EUREG): LIMITED USEFULNESS FOR PREDICTING FIRST-LINE EMPIRICAL TREATMENT EFFECTIVENESS

Not sure what you can access? Learn more about account types.

Introduction

Helicobacter pylori infection is the primary cause of gastritis, peptic ulcer disease, and gastric cancer. Without an effective vaccine, eradication therapy is essential for disease control. However, rising antibiotic resistance worldwide has compromised treatment effectiveness, highlighting the need to evaluate how literature-based resistance rate data can inform the success of eradication regimens in clinical practice.

Aims & Methods

Current study aimed to assess whether such literature-based data could reliably predict the outcomes of first-line empirical eradication therapy.
Antibiotic resistance data for clarithromycin, metronidazole, and levofloxacin were obtained through a systematic review of published studies. Resistance prevalence was calculated for three timeframes: the year of treatment, the preceding year, and a weighted average over the current and previous four years. These rates were matched with data from the European Registry on H. pylori Management (Hp-EuReg), a prospective, real-word study involving first-line empirical H. pylori treatments and their outcomes. Data collected spanned from 2008 to 2024 and encompassed 23 countries. Modified intention-to-treat analyses were conducted using multivariate logistic regression with 10,000 stratified bootstraps, adjusting for covariates such as patient age, sex, country, year of prescription, first-line treatment regimen, proton pump inhibitor dosage, treatment duration, compliance, and assigned resistance values. Additional analyses assessed whether resistance to a specific antibiotic impacted each treatment effectiveness containing that antibiotic.

Results

A total of 18,219 patients from 13 European countries were included in the final analysis. Accounting all first-line empirical treatments, resistance to clarithromycin and levofloxacin in the current year influenced treatment effectiveness in opposite directions. Clarithromycin resistance was associated with a slight increase in treatment success (OR=1.02, 95%CI 1.00-1.03); whereas levofloxacin resistance was associated with a slight decrease (OR=0.98, 95%CI 0.97-1.00, respectively). Both associations had minimal effect sizes with questionable clinical relevance. Resistance to clarithromycin from the previous year was also paradoxically associated with improved treatment effectiveness (OR=1.01, 95%CI 1.00-1.02).
For standard clarithromycin-amoxicillin triple therapy, a higher rate of clarithromycin resistance (both current and over the preceding four years) was slightly associated with reduced treatment success (OR=0.99, 95%CI 0.99-1.00).
For clarithromycin-metronidazole triple therapy, resistance rate to clarithromycin was not associated with effectiveness (OR=0.97, 95%CI 0.93-1.01); while metronidazole resistance showed a slightly association with reduced effectiveness (OR=0.96, 95%CI 0.93-1.00).
For all other regimens evaluated, no significant associations were observed between specific antibiotic resistance rates—whether current or past—and the likelihood of successful H. pylori eradication.

Conclusion

Despite several statistically significant associations between resistance patterns and treatment outcomes, the effect sizes were minimal and of questionable clinical relevance. Thus, the reliability of antibiotic resistance data from external (literature-based) cohorts appears negligible and of limited utility in influencing the clinical choice of first-line therapies for H. pylori infection in real-world settings.

Disclosure

Javier P. Gisbert has served as speaker, consultant, and advisory member for or has received research funding from: Mayoly, Allergan/Abbvie, Diasorin, Richen, Juvisé and Biocodex.
Olga P. Nyssen received research funding from: Mayoly, Allergan/Abbvie, Richen, Juvisé and Biocodex.

LITERATURE-BASED HELICOBACTER PYLORI RESISTANCE DATA INTEGRATED INTO THE EUROPEAN REGISTRY ON H. PYLORI MANAGEMENT (HP-EUREG): LIMITED USEFULNESS FOR PREDICTING FIRST-LINE EMPIRICAL TREATMENT EFFECTIVENESS

Ismail Kirrout 1, Beatriz Nafria 2, Ángeles Pérez-Aísa 3, Bojan Tepes 4, Irina Voynovan 5, Samuel Jesús Martínez-Domínguez 6, Alfredo J. Lucendo 7, Liudmila Vologzhanina 8, Sayar Abdulkhakov 9, Javier Tejedor-Tejada 10, Tatiana Ilchishina 11, Boris Starostin 12, Aiman Sarsenbaeva 13, Matteo Pavoni 14, Oleg Zaytsev 15, Jose Maria Huguet 16, Antonietta Gerarda Gravina 17, Ana Garre Vázquez 18, Monica Perona 19, Sergei Alekseenko 20, M. Soledad Marcos 21, Manuel Pabon-Carrasco 22, Oscar Núñez Martínez 23, Dmitrii Andreev 24, Miguel Areia 25, Jesús Barrio 26, Antonio Moreno 27, Blas José Gómez Rodríguez 28, Pavel Bogomolov 29, Maja Denkovski 30, Igor Bakulin 31, Inmaculada Ortiz Polo 32, Natalia Bakulina 31, Manuel Domínguez Cajal 33, Dmitry S. Bordin 34, Antonio Gasbarrini 35, Ricardo Pinto 36, Mónica Sánchez Alonso 37, Ramón Pajares Villarroya 38, Irene Arteagoitia 39, Manuel Jiménez-Moreno 40, Pablo Parra 18, Olga P. Nyssen 18, Luis Bujanda 2, Anna Cano-Catala 41, Leticia Moreira Ruiz 42, Francis Mégraud 43, Colm O'Morain 44, Nuria Montes 1, Javier P. Gisbert 18

1 Unidad de Metodología, Instituto de Investigación Sanitaria Princesa (IIS-Princesa); Servicio de Reumatología, Hospital Universitario de La Princesa; Plant Physiology, Pharmaceutical and Health Sciences Department, Boadilla del Monte, Spain

2 Department of Gastroenterology, Biodonostia Health Research Institute, Department of Medicine, Universidad del País Vasco (UPV/EHU), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastián, Spain

3 Department of Gastroenterology, Hospital Universitario Costa del Sol, Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Marbella, Spain

4 Department of Gastroenterology, DC Rogaska, Rogaska Slatina, Slovenia

5 A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation

6 Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Zaragoza, Spain

7 Department of Gastroenterology, Hospital General de Tomelloso, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Tomelloso, Spain

8 Gastrocentr, Perm, Russian Federation

9 Kazan (Volga region) Federal university, Kazan State Medical University, Kazan, Russian Federation

10 Department of Gastroenterology, Hospital Universitario de Cabueñes, Asturias, Spain

11 Department of Gastroenterology, SM-clinic, Saint-Petersburg, Russian Federation

12 Saint-Petersburg State Budgetary Institution Healthcare City Policlinic 38, Saint-Petersburg, Russian Federation

13 Department of Gastroenterology, Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russian Federation

14 Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, Bologna, Italy

15 First Clinical Medical Centre, Kovrov, Russian Federation

16 Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain

17 Department of Hepatogastroenterology, University of study of Campania "L. Vanvitelli", Naples, Italy

18 Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain

19 Department of Gastroenterology, Hospital Quirón Marbella, Marbella, Spain

20 Far Eastern State Medical University, Khabarovsk, Russian Federation

21 Department of Gastroenterology, Hospital 12 de Octubre, Madrid, Spain

22 Department of Gastroenterology, Hospital Universitario Virgen de Valme, Sevilla, Spain

23 Department of Gastroenterology, Hospital Universitario La Moraleja, Faculty of Medicine, Universidad Francisco de Vitoria, Faculty of Medicine, Universidad CEU San Pablo, Madrid, Spain

24 Russian University of Medicine, Moscow, Russian Federation

25 Department of Gastroenterology, Portuguese Oncology Institute of Coimbra, Faculty of Medicine of the University of Porto (FMUP), RISE@CI-IPO (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Coimbra, Portugal

26 Department of Gastroenterology, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Valladolid, Spain

27 Department of Gastroenterology, Hospital Universitario Virgen del Rocío, Sevilla, Spain

28 Department of Gastroenterology, Hospital Universitario Virgen Macarena, Sevilla, Spain

29 Universal Clinic Private Medical Center, Moscow, Russian Federation

30 Interni oddelek, Diagnostic Centre, Bled, Slovenia

31 Department of Gastroenterology, Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation

32 Department of Gastroenterology, Hospital Universitario y Politécnico la Fe, Valencia, Spain

33 Department of Gastroenterology and Hepatology, Hospital Universitario San Jorge, Huesca, Spain

34 Department of Pancreatic, Biliary and upper digestive tract disorders, A. S. Loginov Moscow clinical scientific center, Department of outpatient therapy and family medicine, Moscow, Russian Federation

35 Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

36 Department of Gastroenterology, Centro Hospitalar do Porto, Instituto De Ciências Biomédicas de Abel Salazar, Universidade do Porto, Center for Research in Health Technologies and Information Systems (CINTESIS), Porto, Portugal

37 Department of Gastroenterology, Hospital Universitario Santa Bárbara, Ciudad Real, Spain

38 Department of Gastroenterology, Hospital Universitario Infanta Sofía, Faculty of Medicine, Universidad Europea de Madrid, Madrid, Spain

39 Department of Gastroenterology, Hospital Universitario de Cruces, Vizcaya, Spain

40 Department of Gastroenterology, Hospital Universitario de Burgos, Burgos, Spain

41 Gastrointestinal Oncology, Endoscopy and Surgery (GOES) research group, Althaia Xarxa Assistencial Universitària de Manresa, Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central (IRIS-CC), Manresa, Spain

42 Department of Gastroenterology, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelon

43 INSERM U1312 BRIC, Université de Bordeaux, Bordeaux, France

44 Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Stomach & H. Pylori

Submission format

Abstract

Session

H. pylori: Between bench and bedside

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Most popular content

Rate for better recommendations!