Just as with adults, it may be necessary to perform gastroscopy in children, depending on the clinical picture. The procedure for a gastroscopy in children does not differ significantly from the usual procedure in adults. Only the decision when or if a gastroscopy should be performed at all is more critical in most cases.
Indications
Recurring unclear abdominal pain is the most common reason for children to undergo a gastroscopy. They become suspicious as soon as they persist for a very long time and/or recur very frequently. If the general examination of the child and a detailed questioning of the parents (e.g. type of pain, time of occurrence, alleviating circumstances, etc.)
do not find a cause and all other diagnostic possibilities are exhausted, a gastroscopy will be considered. In theory, all other symptoms and complaints that are a reason for a gastroscopy in adults can also be considered in children. These include recurrent severe heartburn, frequent nausea with vomiting, pain or problems swallowing, blood in the stool or vomit, and severe weight loss without a clear cause.
Procedure
The procedure of a gastroscopy in children is absolutely identical to the examination of adults. The examining doctor uses only a smaller, thinner gastroscope and will usually administer a mild sedative. While this short anaesthesia is not absolutely necessary in adults, and is performed on request, it is recommended in children to relieve any anxiety and tension before the examination.
The dose of this sedative is determined in advance by the attending physician on an individual basis according to the child’s weight and age. The child will then not notice the examination itself. In addition, an anaesthetic throat spray is also used during a gastroscopy in children, before the gastroscope is advanced through the mouth, past the larynx, through the oesophagus and into the stomach.
In the meantime, some practices also offer the possibility of using a transnasal approach, which some patients find more comfortable. Like adults, children also lie on their left side during the examination and take a teething ring between their teeth, which should protect both the child’s dentition and the gastroscope from sudden reflex-like biting. From a medical point of view, anesthesia is not absolutely necessary for a gastroscopy in children.
However, a short anaesthesia with a mild sedative is recommended. This reduces anxiety and tension and also prevents trauma. In addition, the examination conditions are much better than with a child who is not anaesthetized.
For the reasons mentioned above, gastroscopy in children is regularly performed with a light anaesthetic. A gastroscopy in children does not take longer than in adults. The actual examination usually takes about ten to 15 minutes.
As a light anaesthesia is usually also given, the necessary time for preparation is added. This includes the placement of a vein access as well as the administration of the anesthetic through this access. After the examination, the child is still sleepy for a while and slowly regains consciousness. A total of about two hours should be planned for the gastroscopy.
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