The Need for Endoscopy in Children

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I have just published an article in Nature reviews of gastroenterology and hepatology which examines the need for endoscopy in children, including upper GI endoscopy and ileo-colonoscopy. The diagnostic positive yield, or another way of putting it is the number of children who have endoscopy in whom positive results are found, varies in different studies, but probably around 40% or so of positive diagnoses is about right. In other words if you are doing too many then this would be a lower figure, if you’re not doing enough this would be a higher figure because you are missing cases of children with various diseases. However it must be remembered that a significant negative result is also helpful because this can show the parents and the child that everything is all right. Doing a full procedure and having a look at all of the bowel, including taking biopsies, is very important in children because in Crohn’s disease, for instance, often just sits in the last part of the small bowel, called the terminal ileum and it’s really important to be able to access this area in children. This comes with experience and skill and this is where the training centre that I run in Sheffield for Paediatric Endoscopy has it place in increasing the skills of trainees and also sometimes those that are already trained.

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