Tuesday 14 March 2017

Endoscopy and Colonoscopy

Your child will be having two GI procedures under anesthesia – an endoscopy and a colonoscopy.

Endoscopy
An endoscopy is a way to look inside the body using a thin, flexible tube with a camera and light on the end. In an endoscopy, the tube goes down the throat (esophagus). This test is done by a gastroenterologist (a doctor who specializes in stomach problems). It is done to diagnose and, in some cases, treat problems with the upper digestive system. The upper digestive system includes the esophagus (food tube), stomach and the duodenum (beginning of the small bowel).

The doctor looks at pictures taken from the camera on a monitor. These pictures give a clear view of the upper digestive system. In many cases the doctor will take biopsies from these areas. Biopsies are tiny samples of tissue that are examined under the microscope by a pathologist. A pathologist is a doctor who looks at tissue to see if there are any diseases. Your child will not have pain from the biopsies.

Colonoscopy
After the endoscopy, your child will also have a colonoscopy. The word colonoscopy means looking inside the colon. The colon, or large bowel, is the last portion of the digestive tract. The instrument that is used to look inside the colon is a long, thin, flexible tube with a tiny camera and light on the end. The gastroenterologist carefully guides the colonoscope up through the anus while looking at pictures from the camera that are shown on a monitor.

In many cases the doctor will take biopsies for the pathologist to examine. There is no pain with a biopsy.

Plan for a bowel cleanout 

Your child’s bowels will need a full cleanout before the procedure. We use medicines for this, not enemas. You will give these medicines at home. Your doctor will tell you when this cleanout should be done.

What can we expect on the day of the endoscopy?
1. Park 
These procedures are done in the Outpatient Procedure Center at Children’s main hospital. To get to this area, park in the Ocean parking garage and check in at the main registration desk on level 6. This is a day procedure. You should plan to be at the hospital for most of the day, but most children do not stay overnight. 

2. Check in
 After checking in, a nurse will take your child into an exam room. Your child will change into a hospital gown. They can keep their underwear and pants on. The nurse will take your child’s temperature, heart rate, and blood pressure and orient you and your child to the GI procedure area. 

3. Talk with the anesthesia doctor 
The anesthesiologist will speak with you about your child’s health history and examine your child. They will explain the type of anesthesia recommended to keep your child comfortable and asleep during the procedure. 
Most children are under general anesthesia, where they are completely asleep, for the procedure. A few children will have lighter sedation so that they aren’t fully asleep.

4. Begin the procedure 
Before the test your child will have several things attached to them: 
• Electrodes (sticker-like patches) placed on the chest to check heart rate and breathing 
• A small probe taped to the toe or finger to watch the oxygen level during the procedure 
• A blood pressure cuff on the arm or leg 

In most cases, you may hold your child or sit next to them while they go to sleep. After your child is asleep, you will be shown to the waiting room while your child goes into the GI procedure room. This is a comfortable, childfriendly room. 

The procedure takes about 30 minutes including the time it takes to get your child ready in the room. After the procedure your child will go to the recovery room. Your child will be in recovery room for about 30 to 60 minutes. As soon as they are awake, they will be brought to you in a Phase II recovery room. 

Your child will be given clear liquids and watched for about 1 hour. When your child is fully awake and able to keep liquids down you will be able to go home.

How soon will I know the test results? 
Your child’s gastroenterologist will meet with you right after the procedure to discuss the findings. Most likely, you will be asked to return for an appointment in 2 weeks to make a new plan of care based on your child’s symptoms and information from the biopsies.

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