Upper GI Endoscopy (Child)

An upper GI endoscopy is a procedure used to visually examine the upper digestive system, which includes the esophagus, stomach, and duodenum (the first part of the small intestine), in children. This examination is performed using an endoscope, a flexible tube with a camera and light on the end.

Reasons for the Procedure

The procedure may be recommended for various reasons, including:

• Evaluating symptoms such as abdominal pain, nausea, vomiting, difficulty swallowing, or bleeding in the digestive tract.
• Investigating the cause of gastrointestinal bleeding.
• Diagnosing conditions like gastroesophageal reflux disease (GERD), ulcers, inflammation, or narrowing of the esophagus.
• Removing foreign objects that have been swallowed.
• Taking tissue samples (biopsy) for further examination under a microscope.

Preparation

To prepare for an upper GI endoscopy, children typically need to:

• Fast for several hours before the procedure to ensure their stomach is empty. The exact fasting period will be determined by the healthcare provider.
• Avoid eating and drinking anything that could interfere with the examination or increase the risk of complications.
• Remove any makeup, including nail polish, as these can interfere with the monitoring equipment.

Procedure

The procedure is usually performed in an outpatient setting. Here’s what happens during the procedure:

• The child will be given sedation to help them relax and reduce discomfort during the examination.
• A local anesthetic may be sprayed into the throat to numb it and prevent gagging.
• The endoscope is gently inserted through the mouth, guided through the esophagus, stomach, and into the duodenum.
• Images from the camera on the end of the scope are displayed on a monitor for the doctor to view.
• Air may be introduced through the scope to inflate the stomach and provide a clearer view.
• Tissue samples (biopsies) may be taken if necessary, which will not cause discomfort due to the sedation.

After the Procedure

Following the upper GI endoscopy:

• The child will be monitored in a recovery area until the effects of the sedation have worn off.
• They may experience some throat discomfort or bloating, which should resolve on its own within a day.
• Eating and drinking can usually resume once the gag reflex returns, typically within an hour after the procedure.
• The results of the endoscopy will be discussed with the parents or guardians, including any findings from biopsies, which may take a few days to come back.

Risks and Complications

While generally safe, there are potential risks and complications associated with an upper GI endoscopy in children, including:

• Bleeding from the site where a biopsy was taken or from any polyp removal.
• Infection, which is rare but can occur as with any invasive procedure.
• Perforation of the digestive tract, although this is extremely rare.
• Allergic reactions to the sedatives used during the procedure.

Conclusion

An upper GI endoscopy in children is a valuable diagnostic tool that allows for the direct visualization and examination of the upper gastrointestinal tract. It can help diagnose various conditions, guide treatment decisions, and improve outcomes for children with digestive issues.