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Pediatric Endoscopy Procedure: What to Expect

Pediatric Endoscopy Procedure: What to Expect

Reviewed by Petar Mamula, MD

Reviewed on

What is a pediatric endoscopy and what does it test for?

A pediatric endoscopy is a safe, common procedure that helps doctors look inside specific organs in your child’s body to diagnose conditions such as ulcers, acid reflux, food allergies, infection, celiac disease, eosinophilic esophagitis and other disorders. It can be used to find the cause of abdominal pain, nausea, vomiting, diarrhea and other gastrointestinal issues.

Before the procedure, your child is given medication (sedation or general anesthesia) so they sleep comfortably and do not feel pain. Then, an endoscope, a thin, flexible tube with a light and camera on the end, is inserted into your child’s mouth to visualize the esophagus, stomach and beginning of the small intestine. Small tissue samples, called biopsies, are collected and sent to CHOP’s pathology lab to help diagnose your child.

Pediatric endoscopy procedures are offered at: 

What conditions can a pediatric endoscopy help diagnose?

Pediatric endoscopy procedures are used most often to diagnose gastroenterology conditions affecting the digestive tract including: 

Other medical specialties also use endoscopy for different conditions, including some listed below. Your child’s care team will explain if this applies to your child. Endoscopy can help us check the:  

  • Respiratory system, for things like chronic lung infections and lung diseases 
  • Nervous system, such as for brain tumors
  • Urinary system, for things like kidney stones and urinary tract infections (UTIs)
  • Head and neck, for any swallowing disorders (dysphagia) 
  • Reproductive system, for things like endometriosis and abnormal uterine bleeding 
  • Joints, for certain cartilage or ligament tears, dislocations and arthritis 

What are the different types of endoscopies?

While there are many different types of endoscopy procedures, they all work in a similar way. In each, a pediatric endoscopist with special training inserts an endoscope – including a flexible tube with special tools and a camera – into a body opening or incision. The scope is then directed to the area of the body that needs to be examined or treated.

The key differences between the types of endoscopy procedure include both the procedure name and type of scope. The names of these procedures typically reflect the organ targeted for inspection. For example, a colonoscopy is an endoscopy that examines the colon. Endoscopes also differ; some are rigid, while others are flexible. Some are large enough to hold tools inside them that can be used to take tissue samples, cauterize wounds and perform other treatments or tests. 

Types of endoscopy procedures include: 

  • Bronchoscopy, which goes in the mouth or nostril to look at the windpipe (trachea) and lungs. 
  • Colonoscopy, which goes in the anus to look at the anus and rectum. 
  • Flexible sigmoidoscopy, which goes in the anus to examine the sigmoid colon and rectum, the last portions of the large intestine.
  • Arthroscopy, which goes in an incision in the skin near a joint to assess damage from conditions like arthritis. One example is a hip arthroscopy.

Your child’s doctor will recommend which endoscopy procedure best fits your child’s symptoms and age.

How to prepare for an endoscopy procedure

For your child’s safety, it is very important that you follow the instructions from your clinical team exactly. If you do not follow their instructions, your child’s procedure may be cancelled.

Before your child’s endoscopy procedure, we may ask you to: 

  • Complete any required pre-tests and procedures. This may include blood or urine tests. 
  • Provide your child’s complete medical history, including any diagnosed or suspected conditions, as well as any medications and supplements they are taking. 
  • Depending on the type of endoscopy, your child may be asked to: 
    • Complete a bowel prep to flush the intestines before any type of endoscopy procedure involving the lower digestive tract (like a colonoscopy). 
    • Stop taking certain medications (i.e., blood thinners, such as aspirin) or switch medications for a short period of time before the procedure.

General guidelines to follow before an endoscopy: 

You will be given specific instructions for your child to follow before their procedure, regarding: 

  • What not to eat or drink the day before and day of the procedure 
  • When to stop or delay prescribed and over-the-counter medications 
  • When only clear liquids are allowed 
  • When breastmilk is allowed  

Instructions may vary depending on the type of endoscopic procedure and your child’s age and development. Your child’s care team will review all instructions with you and will be available to answer your questions. This short, animated video from CHOP explains what your child will see, who they’ll meet and what will happen at the endoscopy visit.

What to expect during an endoscopy procedure?

Depending on the type of endoscopy your child needs, the endoscopy process takes 30 minutes to two hours. In most cases, endoscopy is performed as an outpatient procedure and does not require an overnight stay in the hospital. Instead, your child will come in for the procedure and go home the same day.  

Most endoscopy procedures use sedation – and sometimes general anesthesia – to keep your child asleep, still and pain-free during the test. Once your child is sedated, a physician with special training in the type of endoscopy your child needs, will gently insert the scope and guide it to the area being studied. We often use a numbing medication or spray to make it more comfortable to ease the scope into the proper position and avoid damage to internal organs.  

The scope will include a camera and any tools needed for the procedure. The camera allows the clinician to see your child’s organs on a screen, note any irregularities, and take tissue samples or provide treatment, if needed. 

In select situations, your child may be eligible for transnasal endoscopy (TNE). This non-sedated procedure is used to examine problems in the upper gastrointestinal system such as nausea, reflux and difficulty swallowing. TNE is currently only recommended for patients age 7 or older, who can remain still for the procedure, and who need frequent endoscopies such as children with eosinophilic esophagitis (EoE).

How long does an endoscopy take?

Depending on the type of endoscopy, the area of the body being studied and what type of sedation is needed, an endoscopy procedure typically takes 30 minutes to 2 hours. 

What happens after an endoscopy?

After your child’s endoscopy, the care team will continue to monitor your child. They may feel groggy or weak for a short time while coming out of anesthesia but will be able to drink clear liquids when fully awake. If an IV was placed for the procedure, it will be removed after your child can successfully drink clear liquids and keep them down.

In most cases, your child will be able to go home an hour or two after the test is complete. A nurse will review post-procedure instructions with you and your child, including: 

  • How to treat any slight discomfort to the endoscope’s entry point (like their mouth, nose, throat, anus or incision site) 
  • When normal activities can be resumed 
  • When regular medications can be restarted 
  • When to call the doctor if unusual symptoms appear or your child’s condition deteriorates  

What are the side effects of an endoscopy?

Serious complications from endoscopy are rare. Your child’s care team will review warning signs before you go home.

For most, side effects are mild and are not cause for concern. A few such examples include: 

  • Mild sore throat if the scope was in the throat 
  • Nausea, cramps and/or bloating if the scope was in the intestines 

Your child’s healthcare team can recommend ways to manage any discomfort at home, including over-the-counter or prescription pain medication. 

When will I hear the results of the endoscopy?

Your child’s healthcare provider will let you know when to expect the results of your child’s endoscopy procedure. In some situations, we may be able to discuss findings with you on the same day.  

In other cases, such as when biopsies were taken, we will let you know results as they are ready – typically within 5 to 7 business days. Results may be shared at your child’s follow-up appointment, through the MyChart app, or by mail, email or phone.   

We welcome the opportunity to review the results with you and discuss next steps for your child’s care.  

Advanced endoscopy at CHOP

Children’s Hospital of Philadelphia offers state-of-the-art endoscopic services for infants, children and teens at the Kohl’s GI Nutrition and Diagnosis Center in Philadelphia, and at several locations throughout the region including: 

Other advanced endoscopy procedures available at CHOP include: 

Endoscopy FAQs

Is having an endoscopy painful?

Endoscopy is generally painless but may produce mild symptoms after the procedure such as a sore throat, nausea, gas or bloating. These symptoms generally resolve 1-2 days after the procedure.

Do they put kids to sleep for an endoscopy?

Most pediatric patients are sedated for an endoscopy procedure to keep them still and comfortable during the procedure. Certain types of endoscopies may be performed while your child is awake (such as transnasal endoscopy) but this is only available to some patients, older than 7, who can remain still during the procedure. If you have questions about sedation or general anesthesia, talk to your child’s endoscopy team.  

Can my child eat after an endoscopy?

Your child can resume their normal diet shortly after their endoscopy procedure but may need to eat more slowly or start with a light meal.  

Are there things my child should NOT do after their endoscopy?

We recommend that your child returns home and rests after their endoscopy procedure. They can resume typical activities when they feel better, but most children return to normal activities, like school and play, the next day.  

When should I call the doctor?

If your child has severe pain, bleeding or fever after their procedure, contact your primary care team immediately.  

Family resources

To help your family feel more prepared for their pediatric endoscopic procedure, view these resources: