Gastroscopy and Colonoscopy

GASTROSCOPY:

Gastroscopy is the direct examination of the inside of the esophagus, stomach and duodenum with a fiber optic instrument. It is a procedure that may be necessary for better diagnosis and treatment of upper digestive system diseases.

Gastroscopy (endoscopy) instrument is a fiber optic tube, starting from the thickness of a pencil, with a bright light at the end and a small camera that can be bent at different thicknesses. The image obtained with the camera system is projected onto the screen so that the inner surface of the esophagus, stomach and duodenum can be seen. Tissue samples can be taken (biopsy), polyp can be removed (polypectomy) or bleeding areas can be intervened when necessary (with band ligation, sclerotherapy, endoclips procedures) with a thin wire (biopsy forceps) passed through the cannula in the gastroscope, or swallowed foreign bodies can be removed from the mouth with foreign body forceps.



How should we prepare our child for gastroscopy?
Our child's stomach should be completely empty before the endoscopy procedure. In other words, the child who will undergo gastroscopy should be brought for endoscopy after 6 hours of fasting. Relatives of the patients and pediatric endoscopy unit should be present at least 30 minutes before the examination.

• During this period, your child's vascular access is opened by the nurse and prepared for the gastroscopy procedure.

• Before the procedure, you, as the child's parents, will be asked to sign the sedation and procedure approval documents.

• If you have medications, please inform your nurse and doctor before the procedure.

• Congenital heart disease and if there is a condition that requires the use of prophylactic antibiotics, the doctor and nurse should be informed.

• If your child has any known drug and food allergies, information should be given.
  

Gastroscopy procedure how is it done?

Local anesthetic spray is applied to the throat by mouth to our pediatric patient. This gastroscopy instrument can easily pass through the throat. China is required. Then, the drug is given intravenously by the anesthesiologist to ensure the comfort of the patient. In addition, the patient is given oxygen and the pulse, blood pressure and oxygen saturation in the blood are kept under constant observation during the procedure. The duration of the gastroscopy procedure is approximately 10-15 minutes.
Follow-up after gastroscopy
After gastroscopy, your child is rested in the recovery room for half an hour until the effect of the drugs wears off, and then the vascular access is closed and the patient's relatives are informed about the result of the procedure. is informed. The next appointment is determined. Thus, the patient under treatment, if a biopsy has been taken, is re-evaluated together with the results to be obtained and the treatment is written, and subsequent examination appointments are arranged.

 COLONOSCOPY :
Colonoscopy is a thick, hollow organ. It is the examination of the intestine with a bendable instrument called a colonoscope. Colonoscopy procedure allows us to obtain information about stenosis of the intestine, fistula (joining of the intestines with each other ), abnormalities of the intestinal wall and pathologies in the intestinal cavity. During colonoscopy, we can detect inflamed tissues, remove polyps, recognize tissue structures different from normal (benign and malignant tumors) and ulcers (wounds).

Why do we need to have a colonoscopy in children?

• Colonoscopy can be determined by your child's stool habit, shape, amount. if changes occur, rectal bleeding mixed with stool

• Abdominal pain,

• Weight loss

• Slow growth is observed,

• Anemia (anemia)

• Diagnosis and follow-up of diseases such as Crohn's disease and ulcerative colitis

• Polyp in cases of suspicion

• In the large intestine foreign body

• It is recommended to be performed for screening purposes, especially for our patients who have a history of colon cancer in their first degree relatives.

Preparation before colonoscopy in children

In order for colonoscopy to give a good result, the intestines must be completely cleaned (bowel preparation, colon preparation, bowel cleansing or colon cleansing) is necessary for this 24-36 hours before the intestines are cleaned.

It is useful to prepare for colonoscopy 1 week before.

Things you will need:

• Laxatives: Some Doctors prescribe laxatives. Buy the products recommended by your doctor.

• Wet wipes: Toilet paper can irritate the skin in frequent use, as it will be necessary to go to the toilet frequently. If there are wipes with moist aloe vera and vitamin E, you can get them. These products contain ingredients that soothe irritated skin.

• Rape cream: Apply one of the diaper creams for babies to your rectal area before starting the preparation. Reapply during preparation. This will help prevent and heal skin irritations caused by cleansing.

• Sports drinks (not energy drinks) can help replenish fluid loss the evening before a colonoscopy.

Eat foods that will not cause constipation during the colonoscopy week.

• broths: boiled broth, chicken stock (only broth)

• clear fruit juices (apple, pineapple)

• light tea, compote juice (grainless), ayran

You will need at least 2 liters of fluid to take your laxative, so plan accordingly. Sports drinks or light-colored, flavored drinks can help you drink the medicine more easily.

5 days ago: Adjust your diet

It is recommended that you start consuming more easily digested foods and drinks 5 days earlier. Normally, fiber foods are beneficial for intestinal health, but fibrous food intake is not recommended before colonoscopy, because the intestine is completely empty. It makes it difficult to remove, it may stick to the intestinal wall and cause a dirty appearance during the procedure. Switch to low-fiber foods at least five days before the test. For example:

• white bread

• pasta

• rice

• eggs

• lean meats such as chicken and fish

• Well-cooked vegetables without skin

• Fruit without skin or seeds.

Soft foods A soft food diet should be started at least 48 hours before colonoscopy. Examples of soft foods:

• omelet

• smoothies

• puréed vegetables and soup

Foods to avoid

You should also avoid foods that may be difficult to digest during your colonoscopy or that may be difficult for a camera to enter during your colonoscopy. These include:

• greasy, fried foods

• tough meats

• whole grains

• seeds, cookies

• corn, popcorn

• raw vegetables

• peels

• seeds or nuts

• broccoli, cabbage or lettuce

• legumes

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The cleaning process is done by washing the intestine with plenty of transparent liquids and using drugs that empty the intestine.

The intake of solid foods should be completely stopped 24 hours before the colonoscopy procedure, and until the appointment time (if there is no medical objection, such as the presence of chronic kidney, severe heart and liver failure diseases) a minimum of 8-10 liters of transparent liquids (broth, chicken broth, grain-free soups, compotes, sodas, fruit juices without transparent residue) should be consumed.

You must use a bowel evacuator in the evening before the examination and in the morning of the next day.

Nothing should be eaten until the colonoscopy is performed. and should not be drunk. An average of 6 hours of fasting is desired before the procedure.

How is a colonoscopy procedure performed in children?

By entering the large intestine through the anus, sedatives (sedation) and/or anesthesia space is administered. The process of examining under the monitor with a fiberoptic camera with the sedation it will give is called colonoscopy. After the instrument is inserted through the anus, the entire large intestine and the last part of the small intestine can be examined. Depending on the introduction of air during the procedure, a slight pressure sensation may be felt. Before the procedure, some medications are given to help your child relax. The colonoscopy procedure takes between 10 and 40 minutes. The pediatric gastroenterology specialist performing the examination can take samples for pathological examination from places in the intestine he deems necessary, If your gastroenterologist sees an abnormal lesion, polyp, or small tumor that may cause larger problems in the future, they may be removed during the colonoscopy procedure. Pain is not felt during these procedures.

Follow-up after colonoscopy:

Depending on the introduction of air during the colonoscopy procedure, your child may need to pass gas. Since various sedatives or anesthetic drugs will be administered to prevent your child from feeling pain during the procedure, your child's reflexes are affected for a short time after the procedure. During this period (about 2 hours), sharp, piercing, cutting knives, scissors and other similar tools should not be given to the child. During the 1-hour waiting period after the procedure, never give your child food without asking the nurse and doctor.

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