What is an upper endoscopy?
An upper endoscopy is a procedure that allows doctors to see the upper part of your child’s digestive system or upper gastrointestinal (GI) tract. This includes the esophagus (the swallowing tube), the stomach and the duodenum (the first part of the small intestines).
Why is an upper endoscopy done?
An upper endoscopy allows doctors to investigate symptoms or diagnose conditions (such as celiac disease and eosinophilic esophagitis). An upper endoscopy can also be done to treat bleeding in the esophagus, stomach or duodenum.
Preparing for your upper endoscopy
Your child must follow strict eating and drinking rules before the procedure. Your child’s stomach must be empty before a general anaesthetic. If the eating and drinking instructions are not followed correctly, for the safety of your child, the procedure may be cancelled when you get to the hospital. If your child has special needs during fasting, talk to your doctor to make a plan. If your child is on daily medications, make a plan with your doctor about which medications to take on the day of procedure and when to take them.
Please reschedule or cancel your child’s upper endoscopy if they have:
- a cough, cold, nasal congestion, vomiting or diarrhea, or if they are generally unwell
- been sick with, or exposed to, chicken pox or tuberculosis in the past four weeks
On the day of the upper endoscopy
Arrive at the hospital at least two hours before the planned time of your child’s procedure. After your child is registered they will receive an identification band and be shown to their room. It is important to bring your child’s health card or insurance information when you register.
The nurse will assess your child to be sure they are healthy enough for the test to be completed and the fasting rules have been met. At the time of the procedure, your child will be taken to the procedure room or operating room for the upper endoscopy. Your child will have an intravenous (IV) inserted once they are asleep.
How is an upper endoscopy done?
During an upper endoscopy, a thin flexible tube with a camera on the end is inserted into the mouth and down the esophagus to look at the upper gastrointestinal (GI) tract – the esophagus, the stomach, and the duodenum. In addition to the images taken with the camera, doctors will also take small samples of tissue (called biopsies) for testing.
All children getting an upper endoscopy will receive a general anaesthetic. This means that your child will be given a medication so they sleep through the procedure. If there is a family history of malignant hyperthermia or other reactions to anesthesia, please let your nurse know before the procedure. General anaesthetics are safe, and are given by a specially trained doctor called an anaesthesiologist. The anaesthesiologist will meet with you before the procedure to explain how the anaesthetic is given and to discuss any possible complications.
After the upper endoscopy
When the upper endoscopy is complete, the doctor will speak with you regarding what they saw. The full results of the biopsies should be available a few weeks after the procedure. Expect to be at the hospital for at least two hours after the procedure to be sure your child wakes up safely.
Risks of an upper endoscopy
Upper endoscopy is a safe, low-risk procedure. Very rarely, the following complications can occur:
- Bleeding. If this happens, it can often be corrected immediately at the time of the endoscopy. Rarely, an admission to hospital may be required after the procedure.
- Infection, in which case your child will be given antibiotics.
- Tearing or perforation, in which a hole is caused in the wall of the esophagus, stomach or duodenum. This may require surgery to fix. This is very rare, occurring in approximately one child out of 1000 children who have an endoscopy.
If your child is at a high risk of infection, they may be given antibiotics preventively before the upper endoscopy takes place. However, the likelihood of any of these complications occurring is small. If any of these complications occur, they are usually recognized before your child is discharged home.
Follow-up
Please contact your clinic nurse if you have not received the results within three weeks of the procedure.
When to call a doctor
You should contact your doctor or visit the Emergency Department if you notice these signs and symptoms after the procedure:
- fever
- severe pain, in the chest or abdomen
- increased vomiting
- vomiting blood
- shortness of breath
- blood in the stools, or black stools
- difficulty swallowing
At SickKids
SickKids will call to notify you of your child’s appointment details, as well as where and when to arrive. Upper endoscopy procedures are usually performed on 4C, in the main hospital, on the 4th floor of the atrium (use the main elevators). Some cases are performed in the operating room, in the main hospital, on the 2nd floor of the atrium. Your doctor will decide where the endoscopy will take place.
To change or cancel your appointment on 4C, please contact 416-813-6583. To change or cancel your appointment in the operating room, contact the procedure room nurses at 416-813-7004.
Sick Kids policy allows up to two adults to accompany a child for their procedure. The exception is a breastfeeding infant. If you have other children, please ensure you have made arrangements to have them stay at home on the day of the procedure.
For more information on fasting see Eating and drinking before surgery.
For more information on preparing your child for their procedure see Coming for surgery.
For information about getting to the hospital see Getting to SickKids.