Environmentally friendly pediatric gastroenterology: a narrative review

Medical care might be highly resource-intensive, with a significant contribution to greenhouse gas emissions and waste generation. This narrative review aims to provide a synopsis of the current evidence and strategies to promote a "green" pediatric gastroenterology practice. We conducted a narrative review of current literature, international guidelines, and policy recommendations from global health and gastroenterology organizations. Evidence on sustainable strategies, including hygiene, nutrition, vaccination, diagnostic methods, therapies, telemedicine, and digital health, was synthesized to provide an overview of "green" pediatric gastroenterology. Preventive measures such as breastfeeding, sustainable diets, and vaccination decrease gastrointestinal disease burden and environmental impact. Diagnostic sustainability involves avoiding unnecessary tests, using non-invasive biomarkers, and adopting green endoscopy principles. Treatment innovations, dietary approaches, home-based care, and environmentally conscious drug production should promote eco-friendly management. During follow-up, telemedicine, electronic health records, and non-invasive monitoring minimize waste and emissions.

Preventive strategies, diagnostic tools, treatment options, and follow-up methods will facilitate and promote a more sustainable pediatric gastroenterology. A "green" approach simultaneously advances planetary and child health, aligning with the pediatric mission to safeguard long-term well-being for future generations.

• Hospitals contribute substantially to healthcare's environmental footprint through energy use, waste, and high-impact procedures. • Evidence-based measures already reduce impact without compromising care: prevention (vaccination, breastfeeding, hygiene), rational diagnostics, and telemedicine can lower emissions and waste.

• This review integrates sustainability across prevention, diagnosis, treatment, and follow-up, highlighting practical actions such as endoscopy optimization, selective biopsy, eco-friendlier imaging, and medication stewardship • Diet-forward strategies, recyclable packaging innovations, and structured telemedicine/remote monitoring could reduce emissions while maintaining clinical effectiveness.