Endoscopy in Children
Understanding EGD and colonoscopy procedures

What is an endoscopy?

An endoscopy is a procedure that lets doctors look inside the digestive tract using a thin, flexible tube with a camera and light.

EGD (upper endoscopy): looks at the esophagus, stomach, and the first part of the small intestine (duodenum).
Colonoscopy: looks at the large intestine (colon) and, in children, doctors also try to enter the terminal ileum (TI)—the last part of the small intestine—because it can provide important information for diagnosis.

Both procedures are done while your child is asleep under anesthesia so they are comfortable and do not feel pain.

How long does it take?

- EGD: a short procedure, typically about 5 minutes for a diagnostic test
- Colonoscopy: typically 10–30 minutes, depending on findings and whether both procedures are done together

Preparing for the procedure

- For an EGD, your child must have an empty stomach (no food or drink for a certain number of hours before).
- For a colonoscopy, the colon must be cleaned out ahead of time. This usually involves drinking a special solution (such as Miralax mixed in a clear liquid) to flush out stool, along with a clear-liquid diet the day before.

What are biopsies?

During an endoscopy, the doctor may take biopsies—tiny samples of tissue from the lining of the digestive tract.
- Biopsies help diagnose conditions like celiac disease, inflammatory bowel disease, eosinophilic esophagitis, infections, and others.
- Taking biopsies is safe and painless. The tissue is about the size of a pinhead, and the lining heals quickly.

Safety of endoscopy

- Endoscopy is a common and safe procedure in children.
- The risks are very low, especially in experienced pediatric centers.
- Rare complications may include minor bleeding at a biopsy site, reactions to anesthesia, or (very rarely) a small tear in the lining of the intestine.
- The benefits of accurate diagnosis and guiding treatment almost always outweigh these small risks.

Key points for families

- Endoscopy allows doctors to see the inside of the digestive tract and take small biopsies for diagnosis.
- EGD looks at the upper tract, while colonoscopy looks at the large intestine and often the terminal ileum (TI).
- Colonoscopy requires a cleanout the day before; EGD requires an empty stomach.
- Biopsies are safe, quick, and important for diagnosis.
- The procedures are done under anesthesia so your child is comfortable and pain-free.