What is an upper GI endoscopy and dilatation?

An upper gastrointestinal (GI) endoscopy is a procedure to look at the inside of the oesophagus (gullet), stomach and duodenum using a flexible telescope.

What are the benefits of an upper GI endoscopy and dilatation?

Your doctor is concerned that your child may have a problem in their oesophagus which is causing it to narrow. If there is a narrowing, the endoscopist (the person doing the endoscopy) can dilate the area with an endoscopic balloon or bougie (dilators of different sizes).

The endoscopist can perform biopsies to help make the diagnosis.

Are there any alternatives to an upper GI endoscopy and dilatation?

An upper GI endoscopy without dilatation or a barium meal will help find the cause of your child’s symptoms but they will not improve your child’s symptoms.

What will happen if I decide my child will not have the procedure?

Your doctor may not be able to confirm what the problem is.

What does the procedure involve?

The procedure is usually performed under a general anaesthetic and usually takes 30 to 45 minutes.

The endoscopist will place a flexible telescope (endoscope) into the back of your child's throat and down into their oesophagus.

They will be able to perform biopsies to help make the diagnosis and take photographs for your child’s medical records. The endoscopist can perform a dilatation using one of the following techniques:

• Guidewire and filiform dilators — This involves inserting a guidewire down the endoscope and across the narrowing. The endoscopist will remove the endoscope while keeping the guidewire in place. They will pass dilators of increasing size over the wire to gradually stretch the narrowing.

• Guidewire and balloon dilator — This involves passing a guidewire down the endoscope and across the narrowing. The endoscopist will remove the endoscope, pass a balloon dilator down the guidewire and inflate the balloon to stretch the narrowing.

What complications can happen?

The healthcare team are trained to reduce the risk of complications.

Possible complications of this procedure are shown below. Some can be serious and may even cause death.

Any risk rates given are taken from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for your child.

Endoscopy and dilatation complications

• sore throat
• bleeding
• allergic reaction to the equipment, materials or medication
• damage to teeth
• infection
• making a hole in the oesophagus, stomach or duodenum

What happens after the procedure?

The healthcare team will tell you what was found during the endoscopy and discuss with you any treatment or follow-up care that your child may need. Results from biopsies will not be available for a few days so the healthcare team may arrange for you to come back to the clinic for these results.

Your doctor may want your child to have a chest x-ray or keep your child in for close observation for a short time to check if a hole has been made. If a hole has been made, your child will need further treatment and your doctor will discuss this with you.

Sometimes a narrowing can happen again and your child may need another dilatation.

Summary

An upper GI endoscopy and dilatation is usually a safe and effective way of finding out if your child has a problem with the upper part of their digestive system and treating their symptoms.

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