Navigating the world of healthcare for children can be daunting, especially when it involves procedures like endoscopy. Paediatric endoscopy, while essential for diagnosing and treating gastrointestinal (GI) conditions, requires a unique approach to ensure the safety and comfort of young patients. This blog will delve into what makes paediatric endoscopy different, how it is safely performed, and what parents can expect from the preparation to recovery stages.

What is Paediatric Endoscopy?

Paediatric endoscopy involves using a flexible tube with a tiny camera (endoscope) to examine a child’s digestive tract. This procedure helps doctors diagnose and treat a variety of GI issues, ranging from mild conditions like gastroesophageal reflux disease (GERD) to more severe issues such as inflammatory bowel disease (IBD). The endoscope allows for a close-up view of the esophagus, stomach, small intestine, or colon, depending on the area of concern.

Types of Paediatric Endoscopy:

• Upper Endoscopy (Esophagogastroduodenoscopy – EGD): This procedure is often used to diagnose conditions like GERD, where stomach acid frequently flows back into the esophagus or other upper GI issues. For example, if a child has chronic heartburn or difficulty swallowing, an upper endoscopy might be recommended.
• Lower Endoscopy (Colonoscopy): A colonoscopy is used to examine the lower part of the digestive system, primarily the colon and rectum. It’s commonly performed when a child experiences unexplained GI bleeding or symptoms indicative of conditions like IBD.

In India, the demand for paediatric endoscopy has grown significantly as awareness about digestive health in children increases. Hospitals across the country, including specialized centres like Bangalore Gastro Centre, have seen a rise in these procedures, with success rates that reassure both parents and doctors alike.

Indications for Paediatric Endoscopy

Paediatric endoscopy is not a procedure that is done lightly; it is specifically indicated for certain diagnostic and therapeutic purposes.

Diagnostic Purposes:

• GERD: If your child has persistent symptoms of GERD, such as regurgitation or chest pain, an upper endoscopy can help confirm the diagnosis and assess the severity.
• Celiac Disease: Children showing symptoms like chronic diarrhoea, bloating, or growth delays may undergo endoscopy with a biopsy to check for celiac disease, an autoimmune disorder where gluten damages the small intestine.
• Inflammatory Bowel Disease (IBD): For children with ongoing abdominal pain, diarrhoea, or weight loss, endoscopy helps in diagnosing IBD, including Crohn’s disease and ulcerative colitis.
• GI Bleeding: When a child presents with unexplained bleeding in the digestive tract, endoscopy is crucial for locating the source and determining the best course of treatment.

Therapeutic Interventions:

• Foreign Body Removal: It is not uncommon for children to swallow small objects like coins or toys. Endoscopy is a safe and effective method to remove these foreign bodies without the need for surgery.
• Treating Strictures and Managing Bleeding: In cases where the digestive tract has narrowed (strictures) or is actively bleeding, endoscopy can be used to dilate the strictures or cauterize the bleeding site, providing immediate relief.

Safety and Efficacy of Paediatric Endoscopy

One of the most pressing concerns for parents is the safety of their child during an endoscopy. Fortunately, paediatric endoscopy is generally very safe, with high success rates. Studies show that the diagnostic accuracy of these procedures ranges from 83.5% to 98.7%, meaning that in most cases, doctors can get the answers they need to provide effective treatment.

Complications and Risk Management:

While the overall complication rate is low, some minor issues like a sore throat, bloating, or temporary discomfort are not uncommon. These symptoms usually resolve on their own within a few days. Serious complications, such as perforation (a tear in the GI tract) or significant bleeding, are rare but can occur. When such complications arise, they are typically managed promptly and effectively by the medical team.

In India, where GI disorders in children are becoming more recognized, paediatric endoscopy plays a crucial role in diagnosis and management. For instance, with an estimated 5-8% of older children and adolescents experiencing GERD, many may require endoscopic evaluation to guide treatment.

Ensuring Safe Procedures in Paediatric Endoscopy

The key to a successful paediatric endoscopy lies in the expertise of the healthcare professionals involved.

Role of Experienced Paediatric Gastroenterologists:

Having a skilled paediatric gastroenterologist perform the endoscopy is essential. These specialists understand the nuances of working with children, from calming their fears to adjusting the procedure based on the child’s size and medical needs.

Sedation and Anaesthesia Protocols:

Ensuring that a child is comfortable during the procedure is paramount. Paediatric endoscopies are usually performed under sedation or anaesthesia, and managed by a qualified anaesthesiologist. This not only helps the child remain still during the procedure but also minimizes any discomfort or anxiety.

Parental Involvement:

Educating parents about the procedure is just as important as the procedure itself. When parents understand what will happen and why it is necessary, they can better support their child, reducing anxiety for both. For example, a common approach is to allow parents to stay with the child until the sedation takes effect, offering comfort and reassurance.

Case Example:

Consider a 10-year-old child in Bangalore who experiences severe stomach pain after eating. After consulting with a paediatric gastroenterologist at a local hospital, the child undergoes an upper endoscopy. The procedure, performed by an experienced specialist, reveals that the child has severe GERD, which is treated with dietary changes and medication. The child’s condition improves significantly, and both the parents and child feel relieved, knowing that the procedure was handled with care.

Read more: Gastroscopy: What to Expect from Your Upper Endoscopy Procedure

Preparation and Recovery in Paediatric Endoscopy

Proper preparation and post-procedure care are critical to the success of paediatric endoscopy.

Preparation for Paediatric Endoscopy:

• Pre-Procedure Guidelines: Typically, children may need to fast for several hours before the procedure to ensure a clear view of the digestive tract. Parents might also need to adjust their child’s medications as advised by the doctor.
• Parental Guidance: It is natural for both children and parents to feel anxious about the procedure. Parents can help by explaining the process in simple terms, reassuring their child that they will be okay, and bringing along a favourite toy or blanket for comfort.

Recovery post-endoscopy:

• Post-Procedure Care: After the endoscopy, children are usually monitored until the effects of the sedation wear off. Most can go home the same day, though it’s normal for them to feel sleepy or a bit groggy for a few hours.
• Monitoring for Complications: Parents should watch for signs of complications, such as difficulty swallowing, fever, or severe abdominal pain. If any of these occur, contacting the doctor immediately is essential.
• Return to Normal Activities: In most cases, children can resume their regular activities within a day or two. However, the doctor may recommend a brief period of rest, especially if a biopsy was taken during the procedure.

Importance of Specialized Care

When it comes to paediatric endoscopy, specialized care is paramount. Facilities like Bangalore Gastro Centre are equipped to handle the specific needs of children undergoing these procedures. The combination of experienced professionals, child-friendly environments, and advanced technology ensures that paediatric endoscopies are as safe and effective as possible.

Conclusion

Paediatric endoscopy is a critical tool in diagnosing and treating GI conditions in children. With proper preparation, skilled professionals, and post-procedure care, parents can be confident that their child is in good hands. If your child has been experiencing GI symptoms, it may be time to consult with a paediatric gastroenterologist to explore whether an endoscopy is the right step.