Gastroscopy and Colonoscopy in Children

What is a gastroscopy?

A gastroscopy (upper endoscopy) uses a thin, flexible tube with a light and camera, passed through the mouth. It examines the oesophagus (food pipe), stomach and duodenum (the first part of the small bowel). It usually takes around 10 to 20 minutes.

What is a colonoscopy?

A colonoscopy examines the colon (large bowel) using a similar flexible tube passed through the bottom. Where appropriate, the end of the small bowel (the terminal ileum) is also examined, which is important in conditions like Crohn’s disease. It usually takes longer than a gastroscopy.

Why might my child need endoscopy?

• Suspected coeliac disease
• Suspected or known inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
• Gastrointestinal bleeding
• Persistent gastrointestinal symptoms when clinically indicated
• Swallowing problems or suspected eosinophilic oesophagitis (EoE)
• Monitoring response to treatment, or other specific indications such as polyps

Does my child have to be awake?

In children, gastroscopy and colonoscopy are generally performed under anaesthesia or deep sedation, managed by an anaesthetic team, so your child is asleep and comfortable. The exact approach depends on your child and the procedural setting, and it will be discussed with you beforehand.

Dr Malik performs paediatric gastroscopy and colonoscopy at St Andrew’s War Memorial Hospital, under specialist paediatric anaesthetic care.

What are biopsies?

Biopsies are tiny samples of the gut lining, about the size of a grain of rice or smaller, taken with small forceps through the scope. They are examined under a microscope and can detect microscopic changes — for example in coeliac disease, eosinophilic oesophagitis or early inflammation — even when the lining looks normal.

Do biopsies hurt?

The gut lining does not have the kind of nerves that feel a biopsy, and your child will be asleep during the procedure. Children do not feel the biopsies being taken, and they do not usually cause pain afterwards.

Colonoscopy preparation

For a colonoscopy, the bowel needs to be completely clear so the lining can be seen properly. This usually involves a special diet and bowel preparation medicine in the day or so beforehand. Poor preparation can mean areas are missed or the procedure needs repeating.

Regimens differ depending on age, weight and medical history, so please follow the specific instructions provided for your child’s procedure, and contact the team if you have trouble.

What happens on the day?

Your child will need to fast for a set time beforehand; you will be told exactly when to stop food and drinks. After arriving, you will meet the nursing staff, anaesthetist and gastroenterologist, who will answer questions and confirm consent. A parent can usually stay with their child until they are asleep.

What happens afterwards?

Your child will wake in the recovery area, where you can join them. Some children feel sleepy, a little bloated or have a mild sore throat. Most children go home the same day once they are awake, drinking and comfortable. You will be given advice about eating, activity and what to watch for.

When do results come back?

What was seen during the procedure may be discussed with you on the day. Biopsy results take longer, as the samples need to be processed and examined, and timing varies. A follow-up is arranged to discuss results and next steps.

When should my child see a paediatric gastroenterologist?

Common reasons for endoscopy include coeliac disease, inflammatory bowel disease and eosinophilic oesophagitis.

Endoscopy is arranged by a paediatric gastroenterologist after assessing your child and deciding the procedure is likely to be helpful. It is not needed for every child with gut symptoms.

Dr Malik is especially recognised for his expertise in paediatric endoscopy.

Related children’s gut-health resources