Pediatric Endoscopic Management of Gastrointestinal Bleeding

What is pediatric endoscopic management of GI bleeding?

Endoscopy is a minimally invasive procedure to examine and treat many conditions without surgery. Our pediatric specialists use GI endoscopy to diagnose and treat conditions in the digestive tract, including GI bleeding. Pediatric GI bleeding may occur anywhere along the digestive tract, which includes the esophagus, stomach, small intestine and large intestine.

With endoscopic management of GI bleeding, our doctors use an endoscope, a long, thin, flexible tube with a light and camera at the tip. Your child will receive medicine that helps them relax (sedation) or be in a sleep-like state (general anesthesia) during the procedure.

What are the different types of pediatric endoscopic management of GI bleeding?

The two main types of endoscopic procedures to manage GI bleeding are:

Upper endoscopy

Our GI specialists use upper endoscopy when symptoms point to GI bleeding in the esophagus (food pipe), stomach or first section of the small intestine. In this endoscopic procedure, we pass the scope through your child’s mouth and down their throat into the stomach and upper small intestine.

Colonoscopy (or lower endoscopy)

A colonoscopy, sometimes called lower endoscopy, is a procedure to examine the lower areas of the digestive tract. We use a colonoscopy to check for signs of bleeding in the lower intestine (colon), which includes the lower section of the colon (rectum) and the end of the colon (anus).

What are the benefits of pediatric endoscopic management of GI bleeding?

A key benefit of endoscopic procedures is that doctors can evaluate, diagnose and treat GI bleeding all during the same procedure. Endoscopy allows doctors to quickly identify the site of GI bleeding and provide immediate treatment, which is important if the bleeding is severe.

What are the side effects of pediatric endoscopic management of GI bleeding?

A pediatric endoscopy at any hospital can lead to side effects for some children. These may include:

• Bloating and pain caused by gas

• Sore throat for a day or two

• Nausea or vomiting

After an endoscopic procedure, our nurses monitor your child closely as they wake up. We check their breathing, blood pressure and pulse to make sure things are going well and they are comfortable after treatment.. We may give them clear juice or other liquids before discharge.

What are the risks of pediatric endoscopic management of GI bleeding?

Pediatric endoscopic management of GI bleeding provides safe, effective diagnosis and treatment. As with any procedure, endoscopy carries certain risks, which your child’s doctor will discuss with you before the procedure. Risks, although rare, may include:

• Infection

• Perforation (a tear) inside the digestive tract

• Reaction to medications for sedation or anesthesia

At Children’s Health℠, your child’s health and safety are our highest priorities. We work carefully to minimize any possible risks.

What to expect with pediatric endoscopic management of GI bleeding

Our doctors decide on the type of endoscopic procedure your child will need based on where we believe the GI bleeding is happening. We make this decision based on your child’s symptoms, their test results and our evaluation. The preparation and recovery will also be slightly different for each procedure. We work closely with you to explain what to expect and what you need to do before and after the procedure.

What to expect before Pediatric Endoscopic Management of GI Bleeding

• Your child’s doctor will explain the procedure to you and answer your questions.

• Once the procedure is scheduled, our scheduler will call you and send you a letter with the date of the procedure.

• Our Child Life specialists can help put your child at ease before the procedure. Please ask your child’s care team to have a Child Life specialist meet with you and your child.

• If your child needs anesthesia for the procedure, the surgery department will call 2 days ahead. We will explain what time your child should stop drinking and eating before the procedure, and what time you should check in on the day of.

• We will provide detailed instructions for preparing your child before the procedure and how to take care of them afterward. For a colonoscopy, your child will need to do bowel prep. Download the instructions in English or Spanish.

What to expect during Pediatric Endoscopic Management of GI Bleeding

We will tell you what time to arrive on the day of the procedure so we can prepare your child. Our pediatric anesthesiologist will give your child either:

• Sedation medicine to relax your child to keep them comfortable

• General anesthesia to help them sleep and feel no pain

During the procedure, the gastroenterologist will insert an endoscope through your child’s mouth for an upper endoscopy or through their anus for a colonoscopy. The doctor carefully guides the scope to find the bleeding site. During this same procedure, we may perform other procedures, including:

• Injecting medications at the source to control bleeding

• Placing bands or clips to stop bleeding

• Applying heat (cautery and argon plasma coagulation) to seal bleeding areas

• Removing colon polyps that are bleeding

• Taking small tissue samples to examine in the lab (biopsy)

What to expect after Pediatric Endoscopic Management of GI Bleeding

After the procedure, a nurse will take your child to the post-anesthesia care unit (PACU, also called the wake-up room). As they wake up, the nurse may give your child clear liquids.

Your child's doctor will speak with you about how the procedure went, then you can join your child in the wake-up room. Our care team will provide complete instructions on how to care for your child at home and when they can go back to their daily activities. You can take them home usually after about one hour in the wake-up room.

If we did a biopsy or treatment during the endoscopic procedure, the results usually take about seven days to come back. Your child’s care team will call you with the results.

What questions should I ask my provider about pediatric endoscopic management of GI bleeding?

Some questions you may want to ask your child’s doctor and care team include:

• Will my child need to spend the night at the hospital after endoscopic management of GI bleeding?

• What medications should my child stop taking before endoscopic management of GI bleeding?

• Will my child go home with any special equipment after endoscopic management of GI bleeding?

• How soon will I be able to see my child after endoscopic management of GI bleeding?