title: Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines.
abstract: OBJECTIVE
  Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR) of the literature and a robust consensus process. The present article is a product of a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN).
  
  
  METHODS
  A group of 27 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to ESPGHAN and ECCO members. A list of 23 predefined questions were addressed by working subgroups based on a SR of the literature.
  
  
  RESULTS
  A total of 40 formal recommendations and 68 practice points were endorsed with a consensus rate of at least 89% regarding initial evaluation, how to monitor disease activity, the role of endoscopic evaluation, medical and surgical therapy, timing and choice of each medication, the role of combined therapy, and when to stop medications. A management flowchart, based on the Pediatric Ulcerative Colitis Activity Index (PUCAI), is presented.
  
  
  CONCLUSIONS
  These guidelines provide clinically useful points to guide the management of UC in children. Taken together, the recommendations offer a standardized protocol that allows effective, timely management and monitoring of the disease course, while acknowledging that each patient is unique.
authors: Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel. turnerjd2001@gmail.com
authors: Dan
authors: D
authors: Turner
authors: Arie
authors: A
authors: Levine
authors: Johanna C
authors: JC
authors: Escher
authors: Anne M
authors: AM
authors: Griffiths
authors: Richard K
authors: RK
authors: Russell
authors: Axel
authors: A
authors: Dignass
authors: Jorge Amil
authors: JA
authors: Dias
authors: Jiri
authors: J
authors: Bronsky
authors: Christian P
authors: CP
authors: Braegger
authors: Salvatore
authors: S
authors: Cucchiara
authors: Lissy
authors: L
authors: de Ridder
authors: Ulrika L
authors: UL
authors: Fagerberg
authors: Séamus
authors: S
authors: Hussey
authors: Jean-Pierre
authors: JP
authors: Hugot
authors: Sanja
authors: S
authors: Kolacek
authors: Kaija Leena
authors: KL
authors: Kolho
authors: Paolo
authors: P
authors: Lionetti
authors: Anders
authors: A
authors: Paerregaard
authors: Alexander
authors: A
authors: Potapov
authors: Risto
authors: R
authors: Rintala
authors: Daniela E
authors: DE
authors: Serban
authors: Annamaria
authors: A
authors: Staiano
authors: Brian
authors: B
authors: Sweeny
authors: Gigi
authors: G
authors: Veerman
authors: Gabor
authors: G
authors: Veres
authors: David C
authors: DC
authors: Wilson
authors: Frank M
authors: FM
authors: Ruemmele
mesh_terms: D002648:Child; D002985:Clinical Protocols; D003093:Colitis, Ulcerative / Q000628:therapy*; D032921:Consensus; D005060:Europe; D006801:Humans; D010372:Pediatrics; D012955:Societies, Medical