Upper gastrointestinal endoscopy in pediatric gastroenterology: Diagnostic and therapeutic applications

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.