Mistakes in microscopic colitis and how to avoid them

Filters:

UEG Mistakes In Articles

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Mistakes in microscopic colitis and how to avoid them

Andreas Münch

Summary

AI Generated

Microscopic colitis is an inflammatory bowel disease causing chronic watery diarrhoea, with incidence rates now exceeding classic IBD in some countries and diagnosis requiring colonoscopy with biopsy.

Colonoscopy with biopsy samples is the only way to diagnose microscopic colitis.
Incidence rates of microscopic colitis have been increasing and exceed those of classic IBD in some countries.
Histology distinguishes three subtypes: lymphocytic colitis, collagenous colitis, and the more recently introduced incomplete microscopic colitis.
Once believed rare, microscopic colitis has received more attention in recent decades.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations. United European Gastroenterol J Epub ahead of print 20 Aug 2020. DOI: 10.1177/2050640620951905. [Link]

Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020; 14: 1717–1723. [Link]

Windon AL, Almazan E, Oliva-Hemker M, et al. Lymphocytic and collagenous colitis in children and adolescents: Comprehensive clinicopathologic analysis with long-term follow-up. Hum Pathol 2020; 106: 13–22. [Link]

Guagnozzi D, Arias A and Lucendo AJ. Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders. Aliment Pharmacol Ther 2016; 43: 851–862. [Link]

Kamp EJ, Kane JS and Ford AC. Irritable bowel syndrome and microscopic colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 659–668. [Link]

Wildt S, Nordgaard-Lassen I, Bendtsen F, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567–574. [Link]

Fine KD and Schiller LR. AGA technical review on the education and management of chronic diarrhoea. Gastroenterology 1999; 116: 1464–1486. [Link]

Hjortswang H, Tysk C, Bohr J, et al. Defining clinical criteria for clinical remission and disease activity in collagenous colitis. Inflamm Bowel Dis 2009; 15: 1875–1881. [Link]

Verhaegh BPM, Münch A, Guagnozzi D, et al. Course of disease in patients with microscopic colitis — a European prospective incident cohort study. J Crohns Colitis Epub ahead of print 12 Jan 2021. DOI: 10.1093/ecco-jcc/jjab007. [Link]

10.

Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis — review with a practical approach for pathologists. Histopathology 2015; 66: 613–626. [Link]

11.

Münch A, Mihaly E, Nagy F, et al. Budesonide as induction therapy for incomplete microscopic colitis: a randomized, placebo-controlled multicenter trial (paper submitted).

12.

Daferera N, Hjortswang H, Ignatova S, et al. Single-centre experience with anti-tumour necrosis factor treatment in budesonide-refractory microscopic colitis patients. United European Gastroenterol J 2019; 7: 1234–1240. [Link]

13.

Pihl Lesnovska K, Münch A and Hjortswang H. Microscopic colitis: struggling with an invisible, disabling disease. J Clin Nurs 2019; 28: 3408–3415. [Link]

14.

Hjortswang H, Tysk C, Bohr J, et al. Health-related quality of life is impaired in active collagenous colitis. Dig Liver Dis 2011; 43: 102–109. [Link]

Abstract

Microscopic colitis is an inflammatory bowel disease (IBD) that leads to chronic, watery diarrhoea. First believed to be rare, microscopic colitis has received more attention in recent decades, resulting in increasing incidence rates that exceed those of classic IBD in some countries. Hopefully, it is common practice nowadays to refer patients with chronic diarrhoea for a colonoscopy with biopsy samples taken, as this is the only way to diagnose microscopic colitis. Histology results distinguish between the subtypes of microscopic colitis — lymphocytic colitis, collagenous colitis and the more recently introduced incomplete microscopic colitis.

Topics

IBD

Citation

Münch A. Mistakes in microscopic colitis and how to avoid them. UEG Education 2021; 21: 10–13.

Published

2021

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Mistakes In Articles

New

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Spyridon Pantzios, Ioannis Elefsiniotis, Christos Triantos

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020; 14: 1717–1723. [Link]

Guagnozzi D, Arias A and Lucendo AJ. Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders. Aliment Pharmacol Ther 2016; 43: 851–862. [Link]

Kamp EJ, Kane JS and Ford AC. Irritable bowel syndrome and microscopic colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 659–668. [Link]

Wildt S, Nordgaard-Lassen I, Bendtsen F, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567–574. [Link]

Fine KD and Schiller LR. AGA technical review on the education and management of chronic diarrhoea. Gastroenterology 1999; 116: 1464–1486. [Link]

Hjortswang H, Tysk C, Bohr J, et al. Defining clinical criteria for clinical remission and disease activity in collagenous colitis. Inflamm Bowel Dis 2009; 15: 1875–1881. [Link]

10.

Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis — review with a practical approach for pathologists. Histopathology 2015; 66: 613–626. [Link]

11.

Münch A, Mihaly E, Nagy F, et al. Budesonide as induction therapy for incomplete microscopic colitis: a randomized, placebo-controlled multicenter trial (paper submitted).

12.

13.

Pihl Lesnovska K, Münch A and Hjortswang H. Microscopic colitis: struggling with an invisible, disabling disease. J Clin Nurs 2019; 28: 3408–3415. [Link]

14.

Hjortswang H, Tysk C, Bohr J, et al. Health-related quality of life is impaired in active collagenous colitis. Dig Liver Dis 2011; 43: 102–109. [Link]

Abstract

Liver cancer is the sixth most common cancer and the third leading cause of cancer-related death. Hepatocellular carcinoma (HCC) accounts for about 90% of cases and mostly arises in chronic liver disease, especially cirrhosis. Viral hepatitis remains a leading cause, but alcohol-related disease and MASLD are rising. With immune checkpoint inhibitors transforming HCC management, it is timely to highlight common mistakes across screening, staging, diagnosis and treatment.

Topics

Digestive Oncology Hepatobiliary

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Mistakes In Articles

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Mistakes in abdominal distension and how to avoid them

Elizabeth Barba Orozco, Alberto Ezquerra-Durán

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020; 14: 1717–1723. [Link]

Guagnozzi D, Arias A and Lucendo AJ. Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders. Aliment Pharmacol Ther 2016; 43: 851–862. [Link]

Kamp EJ, Kane JS and Ford AC. Irritable bowel syndrome and microscopic colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 659–668. [Link]

Wildt S, Nordgaard-Lassen I, Bendtsen F, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567–574. [Link]

Fine KD and Schiller LR. AGA technical review on the education and management of chronic diarrhoea. Gastroenterology 1999; 116: 1464–1486. [Link]

Hjortswang H, Tysk C, Bohr J, et al. Defining clinical criteria for clinical remission and disease activity in collagenous colitis. Inflamm Bowel Dis 2009; 15: 1875–1881. [Link]

10.

Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis — review with a practical approach for pathologists. Histopathology 2015; 66: 613–626. [Link]

11.

Münch A, Mihaly E, Nagy F, et al. Budesonide as induction therapy for incomplete microscopic colitis: a randomized, placebo-controlled multicenter trial (paper submitted).

12.

13.

Pihl Lesnovska K, Münch A and Hjortswang H. Microscopic colitis: struggling with an invisible, disabling disease. J Clin Nurs 2019; 28: 3408–3415. [Link]

14.

Hjortswang H, Tysk C, Bohr J, et al. Health-related quality of life is impaired in active collagenous colitis. Dig Liver Dis 2011; 43: 102–109. [Link]

Abstract

Abdominal distension and bloating are among the most frequently misunderstood complaints in gastroenterology. They are often used as interchangeable terms, a conceptual mistake that continues to drive diagnostic errors and ineffective treatment. According to Rome IV, bloating and distension may represent either a primary disorder of gut–brain interaction (DGBI) or occur as symptoms with other DGBIs, such as irritable bowel syndrome (IBS), functional dyspepsia (FD) or functional constipation (FC).

Topics

Neurogastroenterology & Motility

Citation

Barba-Orozco E and Ezquerra-Durán A. Mistakes in abdominal distension and bloating and how to avoid them. UEG Education 2026; 26: 5-9.

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Mistakes In Articles

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Mistakes in hepatitis C and how to avoid them

Ana Catarina Garcia, Gonçalo Alexandrino

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020; 14: 1717–1723. [Link]

Guagnozzi D, Arias A and Lucendo AJ. Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders. Aliment Pharmacol Ther 2016; 43: 851–862. [Link]

Kamp EJ, Kane JS and Ford AC. Irritable bowel syndrome and microscopic colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 659–668. [Link]

Wildt S, Nordgaard-Lassen I, Bendtsen F, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567–574. [Link]

Fine KD and Schiller LR. AGA technical review on the education and management of chronic diarrhoea. Gastroenterology 1999; 116: 1464–1486. [Link]

Hjortswang H, Tysk C, Bohr J, et al. Defining clinical criteria for clinical remission and disease activity in collagenous colitis. Inflamm Bowel Dis 2009; 15: 1875–1881. [Link]

10.

Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis — review with a practical approach for pathologists. Histopathology 2015; 66: 613–626. [Link]

11.

Münch A, Mihaly E, Nagy F, et al. Budesonide as induction therapy for incomplete microscopic colitis: a randomized, placebo-controlled multicenter trial (paper submitted).

12.

13.

Pihl Lesnovska K, Münch A and Hjortswang H. Microscopic colitis: struggling with an invisible, disabling disease. J Clin Nurs 2019; 28: 3408–3415. [Link]

14.

Hjortswang H, Tysk C, Bohr J, et al. Health-related quality of life is impaired in active collagenous colitis. Dig Liver Dis 2011; 43: 102–109. [Link]

Abstract

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Topics

Hepatobiliary

Citation

Garcia A.C and Alexandrino G. Mistakes in hepatits C and how to avoid them. UEG Education 2025; 25: 14-17.

Published

2025

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Podcast Episode

UEG Podcast

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Coeliac disease with David Sanders

David S. Sanders, Pradeep Mundre

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Topics

Small Intestine & Nutrition

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Mistakes In Articles

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos, Ilse Broekaert, Jorge Amil Dias, Matjaz Homan

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020; 14: 1717–1723. [Link]

Guagnozzi D, Arias A and Lucendo AJ. Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders. Aliment Pharmacol Ther 2016; 43: 851–862. [Link]

Kamp EJ, Kane JS and Ford AC. Irritable bowel syndrome and microscopic colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 659–668. [Link]

Wildt S, Nordgaard-Lassen I, Bendtsen F, et al. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567–574. [Link]

Fine KD and Schiller LR. AGA technical review on the education and management of chronic diarrhoea. Gastroenterology 1999; 116: 1464–1486. [Link]

Hjortswang H, Tysk C, Bohr J, et al. Defining clinical criteria for clinical remission and disease activity in collagenous colitis. Inflamm Bowel Dis 2009; 15: 1875–1881. [Link]

10.

Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis — review with a practical approach for pathologists. Histopathology 2015; 66: 613–626. [Link]

11.

Münch A, Mihaly E, Nagy F, et al. Budesonide as induction therapy for incomplete microscopic colitis: a randomized, placebo-controlled multicenter trial (paper submitted).

12.

13.

Pihl Lesnovska K, Münch A and Hjortswang H. Microscopic colitis: struggling with an invisible, disabling disease. J Clin Nurs 2019; 28: 3408–3415. [Link]

14.

Hjortswang H, Tysk C, Bohr J, et al. Health-related quality of life is impaired in active collagenous colitis. Dig Liver Dis 2011; 43: 102–109. [Link]

Abstract

Adequate nutrition is essential for the homeostasis of fluids and nutrients, growth and thriving, especially in children. While the underlying principle of percutaneous endoscopic gastrostomy (PEG) placement is the same for both adults and children—providing a means of enteral feeding through the stomach—the indications, considerations and techniques differ owing to anatomical differences, age-dependent physiological concerns, and the age- and disease-specific needs of the child.

If feeding via nasogastric tube (NGT) or naso-jejunal tube (NJT) is necessary for a prolonged time, placement of a PEG or percutaneous endoscopic gastro-jejunal (PEG-J) tube should be considered. A PEG tube also allows the delivery of medications and venting of the stomach when needed. Nutrition via PEG facilitates the transition to out-of-hospital care and improves the quality of life (QoL) for children and families while improving the outcome of children with chronic diseases.

There are recent clinical guidelines providing guidance for PEG tube placement in children, but little advice on, e.g., choosing the right device for the right patient, details on postoperative management, removal of the PEG tube and other specific cases. The following article provides a combination of evidence-based data and the authors’ clinical experience.

Topics

Paediatrics Small Intestine & Nutrition Stomach & H. Pylori

Citation

Broekaert I.J, Dias J.A, Homan M and Tzivinikos C. Mistakes in gastrostomy insertion in children and adolescents and how to avoid them. UEG Education 2024; 24: 34-38.

Published

2024

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

UEG Standards and Guidelines

Clinical Practice Guideline

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

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non-opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.

Guideline

Clinical Practice Guideline

Topics

Pancreas

Citation

United European Gastroenterology Journal, 2026

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Coeliac disease with David Sanders

Pradeep Mundre

Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana