Endoscopy in one year old?

January 23, 2019 1:37 PM

My 14 month old is scheduled for an upper endoscopy and flexible sigmoidoscopy because of recurrent colicky abdominal pain. Please tell me anything you know about endoscopies, anesthesia, emergence delirium, and eosinophilic esophagitis in toddlers!

Baby banana has had a lot of immune, ear, and GI stuff going on since a very young age (see posting history if you’d like more details). He’s currently experiencing a lot of colicky abdominal pain that seems to be related to food intolerances/non-IgE-mediated allergies. I’d love some anecdata or resources about endoscopy and EOE in this age group.

Specific questions:
* Is there anything we should ask/tell the scheduling nurse or GI doctor before the scope?
* If he had emergence delirium coming out of his ear tube surgery, is it likely to happen again? Is there anything we can do to prevent/manage it?
* A possible diagnosis is EOE. What do we need to know about testing for that? Are there specifics (number of biopsies, etc.) we should ask for?
* What information about the prep, procedure, or recovery (including recovery from biopsies) would have made the process easier for your kid and you?
* Any tips for dealing with fasting in this age group?

Thanks!

posted by bananacabana to Health & Fitness (3 answers total)

Best answer: I have EE and it's pretty much made the last 10 years of my life miserable. So I wish you the very best with Baby banana. I can't speak to the age group specifically, but I've been personally researching EE and trying all the things around it for a decade, including:

Endoscopies: (I've had 3), they're pretty easy / fast, and I've never had any issues following any of them. You do want to carefully follow your doctor / anesthesiologist's guidance around eating and drinking leading up to the procedure. The anesthesia is delivered via IV and knocks you out for the few minutes that the procedure takes. One thing they should be able to tell from it is whether or not BB has any hernias in the esophagus as yet. Also, your insurance may fight you on whether this procedure really requires full anesthesia, which it absolutely does, just be aware of this.

Diagnosis: EE (EOE) as I understand it is best diagnosed from a cross reference of the biopsy and blood work - I'm assuming doctor has already ordered this but if they haven't you may want to get a second opinion.

Other things you didn't ask about but I'll mention:
Allergist: would help to get a full workup / spectrum test done to confirm it isn't allergies.

Acupuncture: I tried this and had no luck but a lot of people say they've had good results.

Dietitian: Could potentially help identify diet hacks, I didn't find the one I saw very useful. I did a lot of research on and probably had the most success anywhere here with the 7 food elimination diet (but that tip didn't come from my dietitian.

Medication: They'll probably recommend a proton pump inhibitor, and possibly a steroid pump (like an asthma one) that's sprayed in the back of the throat to be swallowed, coating the throat. Both are worth a try but don't have high expectations here either.

Good luck. This is a relatively recently discovered disease so treatment is really lagging here. It can be super frustrating.
posted by allkindsoftime at 2:42 PM on January 23, 2019

Best answer: Ask them to test for e-pylori infection in the stomach, before doing a whole bunch of permanent meds. If he has that then some antibiotics will clear it up, and with probiotic s to return his biome to health he won't have a dread, deep pocket condition.
posted by Oyéah at 3:29 PM on January 23, 2019

Best answer: Cincinnati has a great center for pediatric EOE if you want to travel for a consult.
posted by 8603 at 5:38 PM on January 23, 2019