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Should my child have general anesthesia or conscious sedation prior to the biopsy?**

Karoly Horvath, M.D., Ph.D., Associate Professor of Pediatrics; Director, Peds GI & Nutrition Laboratory; University of Maryland at Baltimore: The biopsy is a small piece of tissue, such as from the inside lining of the intestine, that has been removed to look for diseases. The biopsy itself is not painful, because there are no pain-sensitive nerves inside the small intestine. An intestinal biopsy can be done in either of two ways depending on the age of the children and the tradition of the institution. Sometimes a blind biopsy procedure is performed by a biopsy capsule. This is thin flexible tube with a capsule at the tip, which has a hole and a tiny knife inside the capsule. This capsule is introduced into the intestine under fluoroscopy (X-ray) control. Alternatively, with an endoscopy the doctor can see inside the digestive tract without using an x-ray to obtain biopsies. The biopsy specimens are processed and viewed under the microscope to identify or exclude celiac disease. An important basic rule is that the biopsy should be performed safely. For a safe procedure children (and adults) should be sedated. There are two methods of sedation: unconscious (general anesthesia) and conscious sedation. During both kinds of sedation the vital parameters (heart rate, blood pressure, oxygen saturation) of patients are continuously monitored. The method of choice depends on the child.

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Conscious sedation is performed with two different intravenous medications. One of them is a sedative medication (e.g. Versed), which causes amnesia in 80-90% of children, and even older children do not recall the procedure. The second medication is a pain-killer type medication (e.g. Fentanyl), which further reduces the discomfort associated with the procedure. In addition, the throat is sprayed with a local anesthetic in older children, which makes the throat numb and prevents retching at the introduction of the endoscope.

During general anesthesia the anesthesiologist uses sleep-gases (e.g. halothan) and intravenous medications and then places a tube into the trachea. Children are completely unconscious. This is a safer way to perform endoscopy, because the patients are fully relaxed and their airway is protected. However, the anesthesia itself has certain complications.

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2 Responses:

 
tammie
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said this on
16 Feb 2008 9:51:14 PM PDT
I'm worried about what kind of complications you can get from the anesthesia. That's pretty scary to hear. Thanks for this good info.

 
Katie Reeves
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said this on
08 Nov 2013 11:52:25 AM PDT
What kind of complications are there?




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Hi Jmg, Thanks for the upbeat reply and all the info! I'm gonna chase this up and either rule it in or rule or out. Unfortunately I've missed the boat as far as adding the celiac panels to blood test goes this time round as it's scheduled for early this Tue however! I have just gone and splashed out on the biocard home-test... I'm thinking trying it out will be beneficial either way as extra ammo before docs appointment. Have you - or anyone else - much experience on the accuracy of such a test? My understanding is that they have generally good reviews but not sure I'm convinced. http://www.medscape.com/viewarticle/540961 Jen

We've done bloodwork again, not everything is back yet, but so far all except for that same one are normal.

Since my new diet change due to the UC and complete keto I feel great so much energy and a clear mind. I started working on a new business idea, I have always dreamed of the culinary arts and doing a full on kitchen or restaurant. But made due to the cottage home bakery and selling Artisan Almond butters and baked goods at the farmers markets. I wish to expand to full on kitchen, I have a bunch of savory breads and dishes down now, and have a full on menu list with rotating cuisines for a food truck down. I have been planning out designs and what kind it will be for about a month and am actively seeking investors and have a potential one lined up. I have also worked out the truck design and gotten a builder lined up if I can get the funding. The base idea of the truck is Paleo and grain free. No Gluten, Corn, Dairy, Peanuts, Soy, or grains period. I have sources down for all ingredients and a menu consisting of grain free nut based foods of toasted sandwiches, pizza, Stir Fries, and noodle dishes. I have it planned out pretty well am still need a few things. I have been spending my days working out options, going over how I will handle different situations, looking at permits fees cost and always looking for a partner to help out with it lol. Sorta fun and exciting, I never thought with these allergies and this disease I could work in the food industry, I threw this idea under the table years ago, but now I see it can be done if I manage it and use a completely dedicated food truck. While still expensive it brings down the cost of a brick and mortar building and allows me to go to venues where I can sell best like events, etc. I looked over the local food truck booking companies for the DFW area and there are no Dedicated gluten-free trucks, so I have a good market potential. Partnering with them will allow me to advertise and get bookings locally to and they help manage fees and permits.......soo much potential I keep praying it all works out. I even have plans to run a local soup kitchen out of it with donation from farmers market on Sundays help the community.

I was wondering if anyone could assist me in sore throat remedies. Cough drops? Teas? I am gargling with salt water but wanted something else. Anything gluten free obviously. Thanks.

Over the last 1.5 years I have had a rash that will not go away. The rash is around the neck, hairline on the front of my head, the back of my scalp, elbows, knees, shins, parts of my ankle, and buttock. The rash seem to get very itchy during the evening. I did have a skin biopsy completed and blood tests last year and they came back negative. I was on oral steroids when I had the test would this possible skew the results? Also its seems the body parts that are exposed to the sun seem to have the rash. Some Pictures http://s1084.photobucket.com/user/Richard_Brandys/library/