What is an endoscopy?
An endoscopy is a procedure that is used to evaluate a patient’s digestive tract. Two types of endoscopy are an upper endoscopy and a capsule endoscopy.
An upper endoscopy is a look inside the esophagus, stomach and beginning of the small intestine. In this procedure, the doctor passes a long, thin, flexible tube with a light on the end through your child’s mouth and esophagus. The tube goes down into the stomach and small intestine. As the doctor passes the tube, they look at these areas and may take small samples of tissues called biopsies.
A wireless capsule endoscopy is an exam of the small intestine using a capsule containing a tiny camera, which can be easily swallowed by most children. The capsule is about the size of a large vitamin.
Who should undergo an endoscopy?
An upper endoscopy is done to help find the cause of your child’s symptoms, such as abdominal pain or vomiting.
A capsule endoscopy allows for a full look of the small intestine because the capsule travels to places where an endoscope cannot reach or examine. This is important for patients with bleeding lesions in the small intestine that have gone undetected by upper endoscopy and X-ray. Capsule endoscopy has also been useful in the diagnosis of small bowel Crohn’s disease. Your child must be able to swallow pills about the size of a jellybean to have this procedure done.
What happens during an endoscopy?
These tests are performed on an empty stomach. Your child’s care team will instruct you how to prepare for an endoscopy.
For an upper endoscopy, your child will have an IV (intravenous) line placed and will be given medicine through the IV. This will make your child sleepy and very relaxed. The doctor will spray a numbing medicine in your child’s mouth to make the test more comfortable. This does not hurt, but some children do not like the taste.
Throughout the procedure, your child will be attached to a heart monitor by wires connected to three stickers on the chest. They will also have a small-lighted sticker on a finger or toe attached to an oxygen monitor. The test usually takes about 30 minutes to complete.
For a capsule endoscopy, a clinician will measure your child’s waist, height and weight and place eight stickers on your child's abdomen, which will be connected to a recording device about the size of a portable CD player. A loose, soft wrap will be wrapped around your child’s abdomen to keep the stickers in place.
Your child will then swallow the capsule with a small amount of water. The recorder and battery pack will be belted around your child’s waist. The recorder must be worn for about eight hours. The pictures captured by the recorder are downloaded into a computer program and reviewed by a gastroenterologist.
What happens after an endoscopy?
When the upper endoscopy is complete, a nurse will be with your child and carefully observe them during the entire recovery time. When your child is fully awake, they may have clear liquids to drink. Once your child is able to keep liquids down, the IV will be removed. Children do not usually experience discomfort after this test. Some children have a slight sore throat.
Children are usually able to go home about one hour after the test is done. The nurse will review all instructions with you and give you information sheets. Since your child may still be sleepy or unsteady, please arrange to have private transportation to go home. Do not plan to take a bus or the MBTA. If you have not arranged a ride, we may cancel the procedure.
Following a capsule endoscopy, your child may resume normal activities, including exercise, and may resume all medications immediately. Until the capsule passes out of the body, further testing, including any type of MRI, should be avoided. The capsule will pass naturally in a bowel movement, typically in about 24 hours.
How will we be informed of the results?
Your child’s doctor will speak with you as soon as the procedure is done. If biopsies were obtained, it will take about five to seven days for results.