Gastroscopy is a procedure performed to examine the esophagus, stomach, and duodenum (the first part of the small intestine) in order to diagnose issues such as inflammation, peptic ulcers, celiac disease, or bleeding. During the procedure, a flexible tube with a small camera is passed through the mouth by the physician. The procedure is routinely performed at the Pediatric Gastroenterology and Nutrition Institute (around 1,000 procedures per year) for various indications. All pediatric gastroscopy procedures are carried out under deep sedation by experienced pediatric sedationists, ensuring the child not only doesn't suffer but also doesn't remember the procedure.
Before the Procedure
The patient should be fasting from solid food for eight hours before the procedure. Clear fluids (any drink through which the other side of the cup is visible, such as tea with sugar, strained clear soup, and apple juice, including clear juices and jelly) can be consumed up to two hours before the procedure. The referring physician should be informed if the patient has any chronic conditions (such as asthma, diabetes, seizures, etc.), takes any medications, has any drug allergies, or has previously had any reactions to sedation. In such cases, a medical summary letter, along with relevant documents and blood test results, should be provided by the treating physician. The purpose of the letter is to ensure the procedure is performed under the safest conditions. If, for any reason, the patient cannot attend the procedure, they should notify the Pediatric Gastroenterology Institute at 02-6555116 to reschedule.
During the Procedure
The procedure takes place at the Gastroenterology Institute (4th floor) and lasts 15-30 minutes. Every effort is made to minimize waiting time, understanding that fasting and waiting can be particularly challenging for children. However, unexpected medical or technical situations in a hospital environment can sometimes lead to procedure delays. If this occurs, we apologize and ask for your understanding. Patients should arrive half an hour before the scheduled time for registration and preparation. Our unit's waiting room is child-friendly. In some cases, the child might receive a pre-procedure briefing by a staff member before sedation. Before the procedure, you will be asked to sign a consent form for the procedure and sedation. The physician who will perform the procedure and the sedation physician will explain what to expect. Feel free to ask any questions before signing, making sure you understand the reasons for the procedure, alternatives, and risks.
Sedation is usually initiated with a mask and later administered through an intravenous needle, ensuring the child doesn't feel any pain during the procedure. In most cases, sedation is only deep enough to ensure the patient breathes independently and maintains vital reflexes. Once asleep, the accompanying person(s) will be asked to wait outside the room until the procedure is completed. During the procedure, the physician inserts a flexible tube through the patient's mouth, gradually advancing it from the esophagus to the stomach and duodenum. The physician may take a biopsy (a small piece of tissue from the lining of the stomach) for pathology evaluation and, if needed, test for the presence of Helicobacter pylori bacteria in the stomach. Photographs of any abnormal areas may also be taken if found, to be included in the procedure report. While routine, complications are extremely rare, such as intestinal perforation or significant bleeding from the site where the sample was taken. The normal risk for these complications is estimated to be less than 0.01%. If abdominal pain, vomiting, fever, black stools, coughing, or breathing difficulties occur after the procedure, you should immediately contact the treating physician and, if necessary, go to the emergency room. Mild throat discomfort might occur after the procedure, typically lasting a few hours and posing no danger. If significant pain occurs, a doctor should be consulted promptly.
After the Procedure
We use sedation agents with the shortest possible effect duration. After the procedure, the patient will be transferred to a recovery area until the sedation wears off, usually within a few minutes. Before discharge, the physician who performed the procedure will explain the findings, provide a procedure report, and discharge instructions. The patient will be offered clear fluids and can resume eating as usual at home, unless advised otherwise by the physician. Generally, patients can go home an hour to an hour and a half after the procedure. Even if the patient holds a driving license, it's important to ensure they have someone available to drive them home, as driving after sedation is not recommended.
Test Results
Before leaving, make sure you have a contact number to receive the biopsy results. Non-urgent results usually arrive within two to three weeks. To obtain results, contact the Gastroenterology Institute at 02-5645656 and provide a fax number or email address for result delivery. To discuss the results, schedule an appointment with the referring physician and bring the printed gastroscopy report and pathology test results with you.