Gastroscopy in children

introduction

As with adults, depending on the clinical picture, a gastroscopy may also be necessary in children (Gastroscopy).

The procedure of a gastroscopy in children does not differ significantly from the usual procedure for adults.
Only the decision as to when or if mirroring should take place at all is made more critically in most cases.

Indications

Recurring unexplained abdominal pain are the most common reason in children Gastroscopy perform.

These become suspicious as soon as they very long persist and / or very much recur frequently.
Can be found in the general investigation of the child and a detailed questioning of the parents (for example, questions are asked about the type of pain, when it occurred, relieving circumstances ...) never mind and if all further diagnostic possibilities are exhausted, you will think about a gastroscopy.

Also all other symptoms and ailments that are a reason for one in adults Gastroscopy represent, come in theory with children also considered.
These include recurring severe heartburn, frequent nausea with vomiting, pain or Trouble swallowing, Blood in the chair or in vomit as well severe weight loss without a clear cause.

procedure

Of the procedure a gastroscopy in children absolutely identical for the examination of adults.

The examining doctor only uses one smaller, thinner Gastroscope and usually becomes one light sedative administer.
During this brief anesthetic not absolutely necessary for adults is, and is carried out on request, it is ideal for children to possible fears and tensions before the examination to alleviate.
The dose of this sedative is determined by the attending physician individually depending on the weight and age of the child determined in advance.

Please also read our page Anesthesia during a gastroscopy.

The child then does the examination in itself not notice.
In addition, a gastroscopy in children of course also takes place numbing throat spray Use before that Gastroscope over the mouth past the larynx through the esophagus up to the stomach is advanced.
In some practices there is now also the option of having a Access through the nose to choose (transnasal), which some patients find more comfortable.

Like adults, children also lie down during the examination on the left and take one Teether between the teeth, of both the child's dentition and the Gastroscope to protect against sudden reflex-like biting.

Is an anesthetic necessary?

From a medical point of view, anesthesia is not absolutely necessary for a gastroscopy in children. Nevertheless, a brief anesthetic with a light sedative is recommended. On the one hand, fears and tension are reduced and, on the other hand, trauma is prevented. In addition, the examination conditions are much better than with a non-anesthetized child. For the reasons mentioned, gastroscopy in children is usually carried out with a light anesthetic.

Read more on the topic: Anesthesia with a gastroscopy and short anesthesia with propofol

Duration of a gastroscopy in children

A gastroscopy in children does not take longer than in adults. The actual examination usually takes about ten to 15 minutes. Since a slight anesthetic is usually also used, there is also the time necessary for preparation. This includes the creation of a vein access and the administration of the anesthetic via this. After the examination, the child is drowsy for a while and slowly comes to. A total of around two hours should be planned for the gastroscopy.

preparation

Especially with children it is Prepare for a gastroscopy of great relevance and should very carefully be performed.

Just like adults, children need to be able to perform the examination well and obtain good assessment results sober appear for gastroscopy.
In most cases it is sufficient over 6 - 8 hours refrain from eating and drinking.

This period can be difficult, especially for smaller children, so appointments for a gastroscopy mostly in the morning hours to allow the fasting period to run off overnight.

diagnosis

Experience has shown that the majority of children have gastroscoped become, no pathological changes the lining of the digestive tract.
Unfortunately, there is rarely one concrete physical cause recognizable for pain or discomfort.

For this reason too, the indication a gastroscopy in children rather strict and only in justified cases.

In individual cases, a pediatrician or a pediatrician will advise you on this decision more specialized Pediatric gastroenterologistwhich can also provide therapy suggestions for the child's original symptoms and other diagnostic alternatives for clarification.

Risks

If the preparatory measures have been carried out well and the child is comfortingly sedated on the day of the examination, a gastroscopy is also in children very low risk.

Just like adults is one Gastroscopy for children only a minor examination that just a few minutes lasts.
Parents should take care to explain the procedure of the examination to their child again after the consultation with the doctor and, above all, to talk about the child's fears.
Parents should take the child don't be even more frightenedeven if you may be concerned yourself.

The risks of a gastroscopy are comparable to those of Gastroscopies in adults. This includes an uncomfortable numb feeling around the throat as well as hoarseness and irritation of the throat after treatment.

It can also lead to bloating, or gas Eructation come.

Very rare it comes under a Gastroscopy to more serious side effects such as an injury to the stomach wall up to Piercing (perforation), Bleeding or that Inhalation of Saliva or other fluids (aspiration).

Due to the Numb throat the child should also in the period after the procedure, during which the anesthetic is still effective, neither eat nor drinkas there is a risk of swallowing.

Is this possible on an outpatient basis?

A gastroscopy in children is possible on an outpatient basis. In fact, if there are no further examinations pending and it is not an emergency, the gastroscopy is usually performed on an outpatient basis. There is an exception if, for example, a colonoscopy is also to be performed. This is only carried out on children under inpatient conditions. If both a gastroscopy and a colonoscopy are required, it does not make sense to carry out the gastroscopy on an outpatient basis, but rather to have both examinations carried out as part of a short inpatient stay.