Risks and complications of paediatric endoscopy

Endoscopies are very safe procedures, however sometimes things can go wrong, so it’s important that you are aware of what these things might be, just in case.

Possible complications of endoscopy

Endoscopies are carried out every day with most people experiencing no complications at all, but if you do experience complications they can include:

• Bleeding (sometimes called haemorrhage) - this can be caused by the endoscope moving around inside your bowel. It can also be caused by biopsies being taken: even though biopsy samples are tiny (around two or three millimetres) and superficial, there is a small risk of bleeding afterwards. If this happens, the consultant can use a special probe to stop the bleeding if necessary
• Infection - there is a small risk that when the endoscope is going around your bowel, and when biopsies are being taken, bacteria can get into your body. This can lead to a brief temperature. Antibiotics are not usually prescribed in these cases - you can take paracetamol to reduce your temperature whilst your body deals with the infection
• Perforation - Very occasionally, an endoscopic procedure can cause a perforation in the lining of your bowel. There is a higher risk of this complication if you have a lot of active inflammation in your bowel at the time, you are having polyps removed, or having stretching (dilation) of a narrowed section of your bowel. This is a very rare complication, but will require a small operation if it does happen

Because of the small risk of complications, it is important you only have an endoscopy when it is really needed - when the information gained from it is going to improve your care.

A good way of reducing the risk of these complications is to make sure you prepare your bowel as well as you possibly can by taking your bowel prep and avoiding food before your procedure. You can learn more about the importance of bowel prep in this course.

What to look out for at home after your endoscopy

If you begin to feel unwell at home after an endoscopy, it is important you tell someone. This is especially important if you have:

• Severe pain
• Fever - that is not responding to paracetamol
• Persistent bleeding from your bottom

If you have any of these, contact your IBD team straight away and they will assess you and decide if you need further treatment. In the UK you can also call your GP, or call 111. If it is out of hours, you may need to go to A&E.

Endoscopy and your IBD symptoms

A common question asked by patients and families is whether an endoscopy can make your Crohn's disease, ulcerative colitis or IBDU symptoms worse. It is thought that...

• Bowel prep medicines will not affect your IBD, though it will give you lots of diarrhoea for a short time
• General anaesthetic medicines will not affect your IBD. Rarely you can have an allergic reaction to a general anaesthetic; your anaesthetist will discuss this with you before your procedure
• Instruments used during your endoscopy could possibly irritate the lining of your bowel, especially if it is already inflamed. This could lead to bleeding and discomfort

If you have any other questions or concerns leading up to, or after your endoscopy, it’s best to speak to your IBD team.