Pediatric Endoscopic Procedures

Our experienced pediatric gastroenterologists specialize in minimally invasive procedures, known as endoscopy, to diagnose and treat many digestive disorders in children. Doctors across North Texas send their patients to us because we can treat children with complex gastrointestinal (GI) disorders without open surgery. We use the latest, most advanced equipment to carefully examine your child’s digestive tract and provide treatment, often during the same procedure.

What are pediatric endoscopic procedures?

Endoscopy is a nonsurgical procedure to examine and treat a wide variety of conditions. With GI endoscopy, our pediatric specialists diagnose and treat problems in the digestive system. This system includes the throat, esophagus (food tube), stomach, small and large intestines, and the pancreas and bile ducts.

These procedures use an endoscope, a long, thin, flexible tube with a light and camera at the tip. Your child will receive medicine that helps them relax (sedation) or sleep (general anesthesia) for their comfort during the procedure. An endoscope provides color video views of the inside of your child’s digestive tract that other types of imaging often cannot show.

What are the different types of pediatric endoscopic procedures?

Our pediatric gastroenterologists (doctors who specialize in diagnosing and treating GI disorders in children) have years of training and experience in endoscopic procedures. We use these procedures to find the causes of many digestive symptoms, and we can often perform treatment during the same procedure.

We decide on the type of procedure based on the symptoms that your child is experiencing. The pediatric endoscopic procedures our team performs include:

Pediatric upper endoscopy

Also called an esophagogastroduodenoscopy (EGD), an upper endoscopy examines the esophagus, stomach and first part of the small intestine (duodenum). In this procedure, our doctors pass the scope through the mouth and throat. At Children's Health℠, we offer diagnostic and therapeutic esophagogastroduodenoscopy, in which we examine and provide treatment during the same procedure.

Your child may need an upper endoscopy if they have symptoms such as:

• Abdominal (belly) pain

• Difficulty swallowing (dysphagia)

• Indigestion (upset stomach)

• Nausea and vomiting

• Unexplained weight loss

• Upper GI bleeding, such as vomiting blood

Pediatric lower endoscopy

With lower endoscopy, our doctors pass the scope through the anus (opening at the end of the large intestine). Types of lower endoscopy include:

• Flexible sigmoidoscopy, which examines the lower portion of the large intestine, also called the colon

• Colonoscopy, which examines the:

  • Rectum (end of the large intestine)

  • Entire colon

  • Lowest section of the small intestine

Your child may need a lower endoscopy if they have symptoms such as:

• Belly pain

• Chronic (long-term) diarrhea or constipation

• Lower GI bleeding, such as blood in the stool (feces)

• Nausea and vomiting

• Unexplained weight loss

Advanced pediatric endoscopic procedures

Advanced endoscopy includes minimally invasive diagnostic and treatment procedures in which endoscopy is the main tool. Our pediatric gastroenterologists are among a few doctors in a few centers across the country who have training and expertise in advanced pediatric endoscopy procedures.

Our doctors use advanced endoscopy to view not only the digestive tract, but also certain parts of the pancreas, liver and gallbladder. We diagnose and treat many conditions using these advanced endoscopic procedures:

• Endoscopic retrograde cholangiopancreatography

• Endoscopic ultrasound

• Single balloon enteroscopy, by which our doctors can access areas in the small intestines that would otherwise require surgery

What are the benefits of pediatric endoscopic procedures?

When you bring your child to Children’s Health, we become your family’s trusted health partner. Our doctors, nurses, technicians and other health care professionals provide exceptional, compassionate care to make your experience as comfortable as possible.

The benefits of having pediatric endoscopic procedures with our team include:

• Pediatric-trained doctors. In many hospitals, children receive care from doctors who also provide care for adults. Our gastroenterologists and anesthesiologists have completed specialty training in pediatric health care and work exclusively with children. They’re experienced in procedures, techniques, instruments, medications and other care that’s tailored specifically for children.

• Dedicated team of specialized GI nurses. Our specially trained nurses work only in pediatric endoscopy procedures for GI conditions. That means your child receives care from nurses with experience in caring for children who are having endoscopic procedures.

• Less pain and faster recovery. Unlike open surgery or laparoscopic surgery, minimally invasive endoscopic procedures don’t require any incisions (cuts). After the procedure, your child will have less pain and a faster recovery, so they can get back to their usual activities as soon as possible.

What are the side effects of pediatric endoscopic procedures?

At any children’s hospital, a pediatric endoscopy can cause side effects for some children. These may include:

• Bloating and pain caused by gas

• Dehydration due to bowel prep

• Dizziness

• Fatigue (tiredness)

• Fever

• Sore throat for a day or two

• Upset stomach or vomiting

As your child wakes up from the anesthesia after an endoscopic procedure, our nurses monitor your child closely and ensure they’re comfortable. We check their breathing, blood pressure and pulse and may give them clear juice or other liquids before discharge.

What are the risks of pediatric endoscopic procedures?

Pediatric endoscopic procedures are safe and effective, but they have certain risks, like any procedure. Our doctor will discuss with you the possible risks for your child, which may include:

• Bleeding due to biopsy or polyp removal

• Infection

• Perforation (a tear in a wall of the esophagus, stomach, intestines or other areas; very rare)

• Reaction to medications for sedation or anesthesia

At Children’s Health, your child’s health and safety are our utmost priorities, and we work carefully to minimize the risk of complications.

What are Children’s Health’s outcome metrics for pediatric endoscopic procedures?

Each year, our team performs nearly 3,000 general and advanced endoscopy procedures for children. Learn more about our Therapeutic Endoscopy program and the Gastroenterology (GI) Lab at Children’s Health.

What to expect with pediatric endoscopic procedures

Each endoscopic procedure is different, and the preparation and recovery will be slightly different too. Your child’s care team will work closely with you to explain what to expect and what you need to do before and after the procedure.

What to expect before pediatric endoscopic procedures

• Your child’s doctor or nurse practitioner will explain the procedure to you and answer your questions.

• Once the procedure is scheduled, our scheduler will call you and send you a letter with the date of the procedure.

• Child Life specialists are available to meet with your child before the procedure to help put them at ease and know what to expect. Please ask your child’s care team to request a Child Life specialist.

• If your child needs anesthesia for the procedure, the surgery department will call 2 days ahead. We will explain what time your child should stop drinking and eating before the procedure, and what time you should check in on the day of the procedure.

• We will provide detailed instructions for preparing your child before the procedure and how to take care of them afterward. For a lower endoscopy, your child will need to do bowel prep. Download the instructions in English (pdf) or Spanish (pdf).

What to expect during pediatric endoscopic procedures

Your child’s care team will tell you what time you’ll need to arrive on the day of the procedure so we can prepare your child. Depending on the type of procedure, our pediatric anesthesiologist will give your child sedation medicine or general anesthesia:

• Sedation medicine relaxes your child to keep them comfortable during the procedure.

• General anesthesia helps them sleep through the procedure and feel no pain.

During the procedure, the gastroenterologist will insert an endoscope through your child’s mouth for an upper endoscopy or through their anus for a lower endoscopy. The doctor carefully guides the scope to look for swelling, growths and other problems.

• Biopsy

• Endoscopic management of GI bleeding

• Endoscopic pancreatic function testing

• Esophageal dilatation

• Intestinal stricture management

• Percutaneous endoscopic gastrostomy (PEG) placement

• Polypectomy

• Sclerotherapy and band ligation of esophageal varices

What to expect after pediatric endoscopic procedures

After the endoscopic procedure, a nurse will take your child to the post-anesthesia care unit (PACU, also called the wake-up room). As they wake up from the anesthesia, the nurse may give them clear liquids.

Your child's doctor will speak with you about how the procedure went, then you can join your child in the wake-up room. Our care team will provide complete instructions on how to care for your child at home, including recommended foods and a time frame for resuming their daily activities. You can take them home usually after about one hour in the wake-up room.

If we did another test or treatment during the endoscopic procedure, the results usually take about seven days to come back. Your child’s care team will call you with the results.

What questions should I ask my provider about pediatric endoscopic procedures?

Some questions you may want to ask your child’s doctor and care team include:

• Will my child need to spend the night at the hospital after a pediatric endoscopic procedure?

• Are there other test or treatment options for my child?

• What medications should my child stop taking before a pediatric endoscopic procedure?

• Will my child go home with any special equipment after a pediatric endoscopic procedure?

• How soon will I be able to see my child after a pediatric endoscopic procedure?