Pediatric Upper Endoscopy

An upper endoscopy is a test to see inside your child's upper GI (gastrointestinal) tract. The upper GI tract is made up of:

• The tube that carries food and liquid from the throat to the stomach (esophagus).
• The stomach.
• The first part of the small intestine (duodenum).

In this procedure, your child's health care provider passes a thin, flexible tube (endoscope) through the mouth and down the esophagus into the stomach. A small camera is attached to the end of the tube. Images from the camera appear on a monitor in the exam room. During this procedure, your child's health care provider may also remove a small piece of tissue to be sent to a lab and examined under a microscope (biopsy).

Your child may have this procedure to find the cause of conditions, such as:

• Difficulty or pain with swallowing
• Evaluation of gastroesophageal reflux 
• Unexplained abdominal or chest pain 
• Unexplained nausea and vomiting
• Evaluation of malabsorption 
• Upper gastrointestinal bleeding 
• Foreign body or caustic ingestion 
• Placement of feeding tubes 
• Chronic infectious or inflammatory diseases

Tell your child's health care provider about:

• Any allergies your child has.
• All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems your child or family members have had with anesthetic medicines.
• Any blood disorders your child has.
• Any surgeries your child has had.
• Any medical conditions your child has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• A tear or hole (perforation) in the esophagus, stomach, or duodenum.

What happens before the procedure?

Eating and drinking restrictions

Follow instructions from your child's health care provider about eating and drinking, which may include: 

• It is very important for the stomach to be empty at the time of the EGD. Your child must NOT EAT OR DRINK after midnight before the procedure until after the procedure is completed.

General instructions

Ask your child's health care provider about:

• Changing or stopping your child's regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your child's blood. Do not give these medicines to your child before the procedure if your child's health care provider instructs you not to.
• Plan to take your child home from the hospital or clinic.

Find out if your child will be going home right after the procedure, or will he/she be admitted to the hospital for 24 hours.

What happens during the procedure?

• An IV tube may be inserted into one of your child's veins.
• Your child will be given one or more of the following:
  • A medicine to help your child relax (sedative).
  • A medicine to numb the throat (local anesthetic).
  • A medicine to make your child fall asleep (general anesthetic).
• Your child will lie on his or her side on an examination table.
• The health care provider will put the endoscope into your child's mouth and down your child's esophagus.
• The health care provider will use the scope to check the inside of your child's esophagus, stomach, and duodenum. Tissue samples (biopsies) may be taken to be examined.
• The endoscope will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your child's blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines your child was given have worn off.
• If your child is of driving age, do not let your child drive for 24 hours if he or she received a sedative.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider

FREQUENTLY ASKED QUESTIONS 

The following may help you with questions regarding the EGD: 

Q: Is an EGD a safe procedure to do in children? 

A: An EGD is a safe procedure in children and can be performed safely even in newborn infants weighing less than 5 pounds. Complications are very rare. The complications vary and depend on: 

• The type of procedure performed. A routine diagnostic EGD with biopsies is safe. A therapeutic EGD performed to attempt to control bleeding has more risk. 
• The clinical state of the patient. An otherwise well child has very little risk from the sedation or procedure. A child with a severe illness or who is critically ill will have a greater risk of complications. 

Your physician will review the risks and benefits of the procedure as well as alternatives to the procedure with you. If you have any questions about the procedure, please ask your physician. 

Q: Will my child be asleep during the procedure? Will my child remember the procedure? 

A: IV medications will be used to keep your child asleep during the procedure. Your child will be monitored during the entire procedure to be sure that he or she is safe and not in any pain. One of the medications given before the procedure affects short-term memory. This means that your child will not remember the procedure. The medications also help your child to relax before being taken into the procedure room. 

Q: When and what can my child eat after the procedure? 

A: In general, we allow your child to take sips when he or she is awake. If this is tolerated, the diet can be advanced (in an age-appropriate manner). The nurses or Endoscopy Unit team will give you more specific instructions after the procedure. 

Q: Can I watch the procedure? 

A: Parents are NOT allowed to stay in the endoscopy room during the procedure. (Please see the section titled “Preparing Your Child for an EGD.”) We are able to take pictures of what we see during the endoscopy and will be able to review these with you. 

Q: When will I get the results of the procedure? 

A: After the procedure, the physician will review the results with you. Often we have to wait for the pathologist to process and review the biopsies before we can give you the final results. Follow-up will be arranged after completion of your child's procedure.