Hathagoda W, Rajindrajith S, Devanarayana NM. Upper gastrointestinal endoscopy in pediatric gastroenterology: Diagnostic and therapeutic applications. World J Gastrointest Endosc 2025; 17(12): 111386 [DOI: 10.4253/wjge.v17.i12.111386]
Corresponding Author of This Article
Niranga Manjuri Devanarayana, MD, PhD, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western Province, Sri Lanka. niranga@kln.ac.lk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wathsala Hathagoda, Shaman Rajindrajith, Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo 00800, Western Province, Sri Lanka
Wathsala Hathagoda, Shaman Rajindrajith, University Pediatric Unit, Lady Ridgeway Hospital for Children, Colombo 00800, Western Province, Sri Lanka
Niranga Manjuri Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western Province, Sri Lanka
Author contributions: Hathagoda W collected and analyzed the evidence and drafted the initial manuscript; Devanarayana NM and Rajindrajith S were substantially involved in revising it; Devanarayana NM conceptualized the paper. All authors checked the final manuscript before submission.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Niranga Manjuri Devanarayana, MD, PhD, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western Province, Sri Lanka. niranga@kln.ac.lk
Received: June 30, 2025 Revised: August 10, 2025 Accepted: October 27, 2025 Published online: December 16, 2025 Processing time: 170 Days and 22.9 Hours
Abstract
Upper gastrointestinal (GI) endoscopy is considered an essential procedure in pediatric gastroenterology. It has evolved over many decades into a state where it plays a crucial role in providing diagnostic and therapeutic advantages across a broad spectrum of diseases. This review examines its role in diagnosing and managing common pediatric GI conditions, emphasizing notable advancements in techniques, clinical use, and future directions. We conducted a detailed literature survey using PubMed, Scopus, and Google Scholar, and English-language articles were reviewed. This review process included the latest articles, guidelines, and conference papers on pediatric and adult upper GI endoscopy. An upper GI endoscopy is imperative in diagnosing many pediatric GI diseases as it enables visualization of the gut mucosa, obtaining mucosal biopsies from suspicious areas or lesions for histological assessment, and selecting an effective management and follow-up plan. New advancements, including high-resolution endoscopy, narrow-band imaging, and confocal laser endomicroscopy, have revolutionized pediatric endoscopy by improving precision and reducing the need for invasive interventions. Furthermore, recent therapeutic developments in the field, such as endoscopic submucosal dissection and endoscopic mucosal resection, are now being utilized to treat preneoplastic lesions or refractory esophageal strictures. However, despite its usefulness, performing this procedure in children is challenging for various reasons, including the need for sedation, anesthesia, and smaller instrument sizes, the unavailability of trained staff, lack of training facilities, and the absence of dedicated endoscopy suites for children. In conclusion, pediatric upper GI endoscopy plays a pivotal role in pediatric gastroenterology, offering both therapeutic and diagnostic benefits. Progress in the field leads to the development of novel techniques that improve overall patient care, such as artificial intelligence in pattern recognition, which enhances lesion detection, predicts premalignant or pre-inflammatory areas, and minimizes investigator-related errors. Additionally, refining protocols and guidelines is essential to improve the safety, efficacy, and precision of upper GI endoscopy, ensuring the best possible care for children.
Core Tip: Endoscopy plays an essential role in pediatric gastroenterology by enabling accurate diagnosis and offering therapeutic benefits, particularly for complex conditions such as inflammatory bowel disease, coeliac disease, and eosinophilic esophagitis. Technological progress continues to improve diagnostic accuracy, while therapeutic endoscopy helps reduce the need for invasive surgical procedures. Tailored endoscopy training programs, standardized evaluation methods, and clearly defined benchmarks for competence will enhance patient care. More robust research is vital to determine the clinical outcomes of endoscopy and to explore the techniques used in children. Continued progress through innovation and specialized education is crucial for the future of pediatric endoscopic practice.
