Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel.
J Pediatr Gastroenterol Nutr. 2012 Sep;55(3):340-61. doi: 10.1097/MPG.0b013e3182662233.
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).
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.
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.
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.
小儿溃疡性结肠炎（UC）与成人发病的疾病有许多共同特征，但也存在一些独特的考虑因素；因此，治疗方法必须适应这些特殊需求。我们旨在根据文献的系统评价（SR）和稳健的共识过程制定治疗儿童 UC 的指南。本文是欧洲克罗恩病和结肠炎组织（ECCO）和欧洲儿童胃肠病学、肝病学和营养学学会（ESPGHAN）共同努力的产物。
27 名小儿 IBD 专家参与了一个迭代共识过程，包括 2 次面对面会议，在此之前向 ESPGHAN 和 ECCO 成员公开呼吁。23 个预先确定的问题清单由工作组根据文献的 SR 进行处理。
总共提出了 40 条正式建议和 68 条实践要点，对于初始评估、如何监测疾病活动、内镜评估的作用、药物和手术治疗、每种药物的时机和选择、联合治疗的作用以及何时停止药物治疗等问题，达成了至少 89%的共识率。基于小儿溃疡性结肠炎活动指数（PUCAI）提出了管理流程图。
这些指南提供了有临床意义的要点，以指导儿童 UC 的管理。这些建议共同提供了一个标准化的方案，允许对疾病过程进行有效、及时的管理和监测，同时承认每个患者都是独特的。
