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Upper Endoscopy In Children


An upper endoscopy

is also called an upper gastrointestinal (GI) endoscopy, or an esophagogastroduodenoscopy (EGD). A scope (thin, flexible tube with a light and camera) is used to examine the walls of your child's upper intestines. The upper intestines include the esophagus, stomach, and duodenum (first part of the small intestine). An EGD is used to look for problems, such as bleeding, swelling, polyps, ulcers, or infection. An upper endoscopy in children is often used to find the cause of abdominal pain, difficulty swallowing, or nausea and vomiting. It may also be done to remove foreign bodies such as a swallowed coin or toy.

How to prepare your child for an upper endoscopy:

  • Your child's healthcare provider will tell you when your child should stop eating or drinking before his procedure. If your child's procedure will be later in the day, you may be able to give your child clear liquids until 2 to 4 hours before his procedure. Clear liquids include water, oral rehydration solutions (ORS), or juices without pulp. Do not give your child clear liquids that are red or purple. Stop breastfeeding your child 4 hours before his procedure.
  • Your child's healthcare provider will tell you what medicines your child should take or not take on the day of his procedure. If your child is 6 years of age or older, explain what might happen during his procedure, to decrease his anxiety. This may also increase his cooperation and tolerance for the procedure. Your child's healthcare provider may give him medicine to help him relax before the procedure starts.

What will happen during an upper endoscopy:

  • Your child may receive IV sedation or general anesthesia. IV sedation will make him feel sleepy and help him relax during the procedure. General anesthesia may be given to keep your child asleep and free from pain during the procedure. Your child's healthcare provider may have you come into the procedure room until your child is asleep. This may decrease your child's anxiety and help him cooperate with healthcare providers.
  • Your child may also be given medicine to numb his throat. Your child may need to wear a plastic mouthpiece to help hold his mouth open and protect his teeth and tongue. Your child's healthcare provider will gently insert the endoscope through his mouth and down into his throat. Your child may feel pressure in his throat but he should not feel pain. The endoscope will not prevent your child from breathing.
  • Your child's healthcare provider will watch the scope on a monitor. He will take pictures with the scope and look for any abnormal areas. He may gently inject air so he can see your child's digestive tract clearly. Your child's healthcare provider may take tissue samples and send them to the lab for tests. He may remove foreign objects, tumors, or polyps that may be blocking your child's upper intestines. Your healthcare provider may also insert tools through the scope to treat bleeding or place a stent (tube). When the procedure is finished, the endoscope will be slowly removed.

What will happen after an upper endoscopy:

Healthcare providers will monitor your child until he is awake. They will feel your child's stomach and listen to his bowel sounds with a stethoscope. Your child may feel bloated, gassy, or have some abdominal discomfort or distention. Your child's throat may be sore for 24 to 36 hours after the procedure. It is normal for your child to spit up a small amount of blood. Your child may burp or pass gas from air that is still inside his body after the procedure. Your child may need to take short walks or lie on his left side to help move the gas out. Your child's healthcare provider may prescribe (order) medicine depending on what he finds during the procedure. Your child may be able to go home after he is awake and can drink liquids, or he may need to spend a night in the hospital.

Risks of an upper endoscopy:

Your child's esophagus, stomach, or duodenum may be punctured or torn during the procedure. This is because of increased pressure as the scope and air are passing through. Your child may bleed more than expected or get an infection. Your child may have a slow or irregular heartbeat, or low blood pressure, during the procedure. This can cause sweating and fainting. Fluid may enter your child's lungs and he may have trouble breathing. These problems can be life-threatening.

Call 911 for any of the following:

  • Your child complains of pain in his chest.
  • Your child has trouble breathing.

Seek care immediately if:

  • Your child feels dizzy or faints.
  • Your child has trouble swallowing.
  • Your child's bowel movements are very dark, black, or you can see bright red blood in them.
  • Your child's stomach is very painful, feels hard, and is larger than usual.
  • Your child vomits blood.

Contact your child's healthcare provider if:

  • Your child has a fever or chills.
  • Your child cannot pass gas.
  • Your child does not have a bowel movement for 3 days after his procedure.
  • Your child has nausea or is vomiting.
  • Your child's skin is itchy, swollen, or he has a rash.
  • You have questions or concerns about your child's condition or care.

Care for your child:

  • Limit your child's activity after the procedure. Have your child lie on the couch or rest quietly until the day after his procedure. He may feel tired and need frequent naps. Your child can take short walks to the bathroom or around the house to help pass gas. He should not play sports or do vigorous activity after his procedure. He may be able to go to school or return to daycare the day after his procedure. Ask your healthcare provider when your child can return to his normal activities.
  • Relieve your child's gas and discomfort. Have your child lie on his left side. He may need to take short walks to help move the gas out. Give your child small meals until his bloating has gone away. Start with clear liquids such as juice without pulp. If he does okay with clear liquids, start giving him his usual foods. Ask your child's healthcare provider if your child needs to be on a special diet.
  • Relieve your child's sore throat. Give your child crushed ice or flavored ice pops.

Follow up with your child's healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.