Polypectomy Procedure

Endoscopies and colonoscopies are similar in nature. Both use an endoscope — a long, thin, flexible tube equipped with LED lights and a tiny video camera — to look inside a section of your child’s gastrointestinal tract.

• An endoscopy is used to look inside your child’s esophagus, stomach and small intestines. It is inserted through her mouth, and passed down the esophagus.
• A colonoscopy is used to look inside your child’s colon and large intestine. It is inserted through her rectum and passed up into her large intestine.

The video camera on the tip of the endoscope feeds to several monitors in the room, so that your child’s medical team can clearly see the walls of her GI tract and whether there are any polyps that need to be removed.

Even though the endoscope tube is very tiny, it is divided into two “channels.” The doctor can use the channels to:

• transfer air into the GI tract, to make sure there’s enough room for what he or she needs to do
• deliver medicine such as steroids straight into your child’s GI tract
• slide tools through that will allow him or her to remove a polyp

Most often, yes. We have many different sizes of endoscopes, including a special one for our youngest patients.

Since the gastrointestinal tract doesn’t have pain sensors, your child will not feel any pain; and our staff will be paying very close attention to make sure that she is sleeping comfortably. If she is having an endoscopy, her throat may feel a little bit scratchy afterward, and if she is having a colonoscopy, she may feel a bit bloated, but these complications most often clear up quickly.

Since endoscopies and colonoscopies let your child’s doctor look at the walls of your child’s digestive tract, it’s important that it is as clean and empty as possible. There are several steps that must be followed:

Your child shouldn’t take aspirin for one week before the procedure, and shouldn’t take medicines containing ibuprofen or naproxen for four days before the procedure. It’s a good idea to double-check by reading the label of any medicines your child is taking, but some of these medicines include

• Motrin®
• Advil®
• Pediaprofen®
• Aleve®
• Naprosyn®

Special instructions for endoscopy

Your child must have an empty stomach for an endoscopy. Here are some guidelines to follow:

After midnight the night before your child’s procedure, do not give her any:

• solid food
• milk
• milk products
• formula
• juices with pulp, such as orange juice, pineapple juice, or grapefruit juice

Your child can have clear liquids (including water, breast milk, apple juice, cranberry juice, Pedialyte®, and Gastorade®) up until the times below:

• if your child is younger than 6 months — two hours before the test time
• if your child is older than 6 months – three hours before test time

Special instructions for colonoscopy

You’ll receive information in the mail about how to prepare your child’s bowel for her colonoscopy. This will include having her follow a special diet for a short time and take laxatives.

A gastroenterologist (GI) — a doctor who specializes in the gastrointestinal system — will perform the procedure. There will also be a nurse present, who will carefully observe your child for the entire time.

Polypectomies are most often performed in our Endoscopy Unit or Gastroenterology Procedure Unit (GPU). Depending on scheduling, sometimes they may also be performed in the operating room. Your child’s doctor will determine the best location, and if your child is scheduled for the operating room, a nurse will call you the day before and tell you where to come.

We ask that you wait for your child in the GPU Family Waiting Area, or elsewhere in the hospital.

First, your child will be given medicine intravenously (through an IV) to help her get very sleepy and relaxed or fall asleep. If your child is having an endoscopy, the doctor will spray a numbing medicine in her mouth to make the test more comfortable.

She will be attached to a heart monitor by wires connected to three stickers on her chest, and also have a small lighted sticker on one of her fingers or toes that is connected to an oxygen monitor.

The doctor will then gently move the endoscope into place. If your child has a polyp, the doctor will slide a special tool down the endoscope to remove it from your child’s body. The polyp will be sent to the lab for testing.

If your child is having an endoscopy, it usually takes around 30 minutes. A colonoscopy usually takes anywhere from 45 to 90 minutes.

When the procedure is complete, the doctor will speak with you in the family waiting area. From there, a nurse will bring you to the recovery area to be with your child.

In the recovery area, a nurse will be with your child and carefully observe him or her during the entire recovery time. When she is fully awake, she may have clear liquids to drink. Once your child is able to keep liquids down, the IV will be removed. While some children may have a slight sore throat, most don’t experience any discomfort after the test.

Children are usually able to go home about one hour after the procedure is done. Before you leave, the nurse will review all instructions and give you information sheets to take with you.

Since your child may still be sleepy or unsteady, please arrange to have private transportation to go home (i.e., not the bus nor the MBTA). If a ride has not been arranged, the procedure may be canceled.

Your doctor will speak with you as soon as the procedure is done. If biopsies were obtained, it will take about five to seven days for results.

If you have any questions about the procedure, call the GI/Endoscopy Unit at 617-355-6172 between 8 a.m. and 4 p.m. Ask to speak to one of the nurses.

For emergencies, you can call a GI doctor 24 hours a day. Call the hospital page operator at 617-355-6369 and ask for the GI fellow on call.