Dr. Gustavo Stringel, the Surgeon-in-Chief at Maria Fareri Children’s Hospital in Valhalla, New York, specializes in minimally invasive surgeries. Dr. Stringel has performed many pediatric endoscopies to diagnose and treat diseases of the digestive tract. Like many in his field, Dr. Gustavo Stringel must frequently explain to parents how he decides when an endoscopy is justified and when it is not.

The North American Society for Pediatric Gastroenterology and Nutrition (NASPGN) has issued a set of guidelines for pediatric endoscopies. These procedures require anesthesia and can be very expensive. Like all procedures, they carry risk. Therefore, the NASPGN recommends that doctors perform pediatric endoscopies only when they will provide diagnostic or therapeutic value to the patient.

For instance, these procedures, which involve inserting a small flexible tube with a light and a camera into a patient’s digestive tract, can locate the source of gastrointestinal bleeds and determine the source of poor weight gain and stooling issues. On the other hand, they should not be used in patients whose gastrointestinal issues are well controlled. For example, a patient with simple reflux who responds well to medication does not need an endoscopy. If a child has issues with constipation but laxatives resolve them, there is no need for this procedure. The NASPGN recommends that endoscopy be used only in cases in which it will increase quality of life and the potential benefits outweigh potential risks.