{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T11:59:36Z","timestamp":1794484776863,"version":"4.9.1"},"reference-count":502,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100018353","name":"European Crohn's and Colitis Organisation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018353","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Society for Paediatric Gastroenterology Hepatology and Nutrition","id":[{"id":"https:\/\/ror.org\/018b60f22","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To provide an updated, evidence-based European Crohn\u2019s and Colitis Organisation [ECCO]\u2013European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN] guideline for the management, monitoring, and long-term care of pediatric Crohn\u2019s disease [CD].<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A multidisciplinary panel of 27 experts followed ECCO Standard Operating Procedures for guideline development. A systematic review of studies published between January 2018 and October 2024, with targeted updates through June 2025, was conducted across MEDLINE, EMBASE, and Cochrane Central. Evidence was graded using the Oxford Centre for Evidence-Based Medicine levels. Draft statements underwent two Delphi voting rounds involving the guideline panel, ECCO National Representatives, and an international sounding board; statements achieving\u2009\u226580% agreement were accepted.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This guideline provides updated recommendations across major domains of pediatric CD care, including risk stratification, treatment targets, induction and maintenance strategies, nutritional therapies, therapeutic drug monitoring, and the roles of imaging and endoscopy. High-risk patients should start anti-TNF therapy as first-line treatment, with proactive and reactive therapeutic drug monitoring to enhance efficacy. For low-risk luminal disease, exclusive enteral nutrition or the Crohn\u2019s Disease Exclusion Diet with partial enteral nutrition are preferred induction options. Long-term management emphasizes achieving endoscopic remission, normal growth, improved quality of life, and reduction of bowel damage. This guideline also reviews emerging advanced therapies, including biologics and small molecules, which are increasingly used in practice but generally not yet approved for pediatric CD, to inform clinicians about their potential role.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This updated ECCO\u2013ESPGHAN guideline integrates new pediatric evidence with contemporary adult data and treat-to-target principles, providing practical recommendations to support personalized, multidisciplinary, and proactive management aimed at improving long-term outcomes in pediatric CD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag084","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:44:34Z","timestamp":1780487074000},"source":"Crossref","is-referenced-by-count":7,"title":["Management of Pediatric Crohn\u2019s Disease: an ECCO-ESPGHAN Guideline Update"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5980-2954","authenticated-orcid":false,"given":"Dror S","family":"Shouval","sequence":"first","affiliation":[{"name":"Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children\u2019s Medical Center of Israel , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-5964","authenticated-orcid":false,"given":"Iva","family":"Hojsak","sequence":"additional","affiliation":[{"name":"Referral Center for Pediatric Gastroenterology and Nutrition, Children\u2019s Hospital Zagreb, University of Zagreb Medical School , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-7305","authenticated-orcid":false,"given":"Erasmo","family":"Miele","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics, University of Naples \u201cFederico II\u201d , Naples,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5992-8247","authenticated-orcid":false,"given":"Christiane","family":"Sokollik","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern , Bern,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9661-0070","authenticated-orcid":false,"given":"Dan","family":"Turner","sequence":"additional","affiliation":[{"name":"The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition, Eisenberg R&D Authority, Shaare Zedek Medical Centre, The Hebrew University , Jerusalem,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9170-8415","authenticated-orcid":false,"given":"Kaija-Leena","family":"Kolho","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Children\u2019s Hospital, University of Helsinki and HUS , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5082-7634","authenticated-orcid":false,"given":"Rotem","family":"Sigall-Boneh","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Unit, The E. 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