How to prepare your child for an endoscopy

By Dr Rohan Malik

Paediatric gastroenterologist in Woolloongabba, Brisbane

Hearing that your child needs an endoscopy can sound daunting, particularly if they’ve never had a hospital procedure before.

Children can have their own questions too. What will happen? Will it hurt? Will I be awake? And perhaps the question parents dread most: Why do I have to have it?

While you can’t necessarily remove every worry, helping your child understand what to expect can make the experience feel much less unknown.

First, what is an endoscopy?

An upper gastrointestinal endoscopy allows a paediatric gastroenterologist to look inside the upper part of your child’s digestive system.

A thin, flexible tube with a tiny camera is passed through the mouth to examine areas including the oesophagus, stomach and the first part of the small intestine. Small tissue samples, called biopsies, may also be taken for testing.

An endoscopy can help investigate a range of gastrointestinal problems, including persistent abdominal symptoms, swallowing difficulties, coeliac disease and inflammation of the digestive tract.

Children are generally given an anaesthetic for the procedure, so your treating team will explain exactly what will happen before, during and after your child’s endoscopy.

How much should I tell my child?

This depends partly on their age and personality.

Some children want to know every detail. Others cope better with a simple explanation of where they’re going, why they’re going and what will happen.

The important thing is to be honest without overwhelming them.

Rather than saying, “There’s nothing to worry about”, you might explain that the doctor needs to take a closer look inside their tummy to find out what has been making them feel unwell.

Give them opportunities to ask questions, and if you don’t know an answer, it’s perfectly fine to say so. You can write the question down and ask the healthcare team together.

Choose your timing

You don’t necessarily need to tell a young child about their endoscopy weeks in advance.

Younger children often benefit from being told closer to the procedure, while older children and teenagers may want more time to understand what is happening and ask questions.

You know your child best. Think about how they usually respond to upcoming events and how much preparation helps them feel secure rather than giving them more time to worry.

Let them know what the day might be like

Often it’s the unfamiliar details rather than the endoscopy itself that children worry about.

Knowing that they’ll meet doctors and nurses, change into hospital clothes, have an anaesthetic and spend some time recovering afterwards can make the day feel more predictable.

Depending on your child’s age, it may help to talk through the day in sequence: We’ll go to the hospital, we’ll meet the team, they’ll get you ready, you’ll go to sleep for the procedure, and I’ll see you afterwards.

Your hospital will give you specific instructions about fasting, medications and when to arrive. Follow these carefully, as they are important for your child’s safety and for the procedure to go ahead as planned.

Don’t promise that nothing will be uncomfortable

It’s natural to want to reassure your child by saying, “It won’t hurt.”

But it’s better to be reassuring and honest.

There may be parts of the hospital experience they find uncomfortable or upsetting, such as having a cannula inserted or feeling a little different when they wake from the anaesthetic.

You don’t need to introduce fears they haven’t thought of, but if your child asks a direct question, give them a simple and truthful answer. If you’re unsure what they’ll experience, ask the healthcare team how best to explain it.

Give your child some control where you can

Having an endoscopy isn’t their choice, but there may be small things that can be.

Perhaps they can choose what comfort item to take to hospital, what to watch while they’re waiting or what they’d like to do once they’re home and feeling better.

For older children and teenagers, involve them in conversations with the medical team and encourage them to ask their own questions.

Small choices can help children feel more involved in what’s happening to them.

What if my child is particularly anxious?

Tell the healthcare team.

This is especially important if your child has had a difficult experience with a previous medical procedure, is very frightened of needles or hospitals, or has additional sensory, communication or developmental needs.

Knowing this beforehand gives the team an opportunity to consider how best to support your child.

Preparing yourself matters too

Children are very good at noticing when their parents are worried.

You may understandably have your own concerns about the procedure or what the endoscopy might find. Asking your questions before the day can help you understand what to expect and make it easier to support your child.

Remember why the endoscopy has been recommended in the first place. It’s an opportunity for your child’s gastroenterologist to gather information that can’t always be obtained from symptoms, blood tests or scans alone.

For many families, that means getting closer to an answer, and to the right treatment for their child.