Introduction:

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by esophageal dysfunction, which may progress to fibrosis or stricture formation if left untreated.

Objective:

To develop evidence-based recommendations through expert consensus for the treatment of EoE in patients under 18 years of age.

Methodology:

A multidisciplinary panel of 16 experts from the Colegio Colombiano de Gastroenterología, Hepatología y Nutrición Pediátrica (COLGAHNP), including allergists, pathologists, adult gastroenterologists, and four international experts, formulated 18 questions (8 diagnostic and 10 therapeutic). A systematic literature search was conducted, analyzing clinical practice guidelines (CPGs), randomized controlled trials (RCTs), and systematic literature reviews (SLRs) from the past 10 years. A total of 27 recommendations (12 diagnostic and 15 therapeutic) were developed and subjected to two rounds of voting using a modified Delphi method. The study was sponsored by COLGAHNP.

Results:

Consensus agreement exceeded 90% for all recommendations. Treatment should be individualized and multidisciplinary, led by pediatric gastroenterologists. Therapeutic strategies are based on an “upward” elimination diet approach, beginning with a single food, the use of proton pump inhibitors, topical corticosteroids, monoclonal antibodies, and, in selected cases, esophageal dilation. Follow-up should incorporate validated tools, such as PEEESv2. Patients should also be prepared for transition into adult care.

Conclusion:

This consensus provides evidence-based treatment recommendations for EoE for patients, families, and healthcare payers within the Colombian and broader Latin American context.

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