Practical Pediatric Gastrointestinal Endoscopy

Indications for diagnostic esophagogastroduodenoscopy (EGD) and/or ileocolonoscopy are provided in algorithms (Figures ). The aim of these algorithms is to provide a guide to when the endoscopy might be necessary based on symptoms (chronic vomiting, dysphagia, chronic iron deficiency anemia, chronic abdominal pain, chronic diarrhea and lower GI bleeding).

Endoscopy is not usually indicated in older children in evaluation of functional GI disorders, including self‐limited abdominal pain, constipation, and encopresis.

Esophagogastroduodenoscopy is not indicated in uncomplicated GER. In addition, it is not indicated for infants or children without overt regurgitation presenting with only one of the following: unexplained feeding difficulties (for example, refusing to feed, gagging or choking), distressed behavior, faltering growth, chronic cough or hoarseness. It is, however, to be considered for those in whom reflux‐type symptoms persist after 1 year of age and in those presenting with dysphagia (a classic presentation of EE). Other considerations include patients with reflux‐type symptoms and refractory iron deficiency anemia and those presenting with other complication factors such as faltering growth.

The reader is referred to the relevant chapters for the following diagnostic indications: eosinophilic esophagitis, Helicobacter pylori , CD, IBD, and less common pathologies ( Chapters 20– 24, 32, and 42).

The reader is referred to the appropriate chapters dealing with the following: upper gastrointestinal bleeding; foreign body removal; stricture management; polypectomy; PEG placement, and less common interventions.

Indications for therapeutic applications of EGD are listed in Table 10.1and for therapeutic ileocolonoscopy in Table 10.2.

See companion website for videos relating to this chapter topic: www.wiley.com/go/gershman3e

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