Fibre‐optic techniques for investigation of gastrointestinal diseases in children

A standard text, such as Paediatric gastrointestinal disease (l), lists a large number of indications for upper endoscopy, varying from bleeding to treatment of oesophageal strictures. Likewise, a list of indications for colonoscopy (1) shows a similar wide range from rectal bleeding to surveillance of a child with a family history of familial polyposis. However, this symposium focuses on immune mechanism and methods. Hence, in this context, it is the ability to obtain endoscopic biopsies that makes endoscopy relevant to study of immune mechanisms in the gut. Although immune mechanisms can be involved in oesophagitis and gastritis, it is chiefly colitis where immune mechanisms are increasingly a focus for research. So the rest of this article is confined to lower endoscopy. However, in the United States and elsewhere, particularly in adult gastroenterology, it has become the practice to biopsy the small intestine endoscopically . I deplore this, as I believe that, unless a Crosby capsule is attached to the endoscope, endoscopic J. A. Walker-Smith, Academic Department of Paediatric Gastroenterology, Queen Elizabeth Hospital for Children, London E2 8PS, United Kingdom