Exploring endoscopy sedation experiences in young adults with pediatric-onset inflammatory bowel disease after transfer to adult gastroenterology care

Background Sedation practices differ between pediatric and adult endoscopy units and may shape how patients with inflammatory bowel disease (IBD) experience procedures after transfer to adult care. Objectives To evaluate endoscopy-related experiences in pediatric and adult settings among young adults with pediatric-onset IBD following transfer to adult gastroenterology care. Methods We conducted a single-centre, cross-sectional survey at an academic institution (June 2024 to February 2025) among young adults (18-25 years) with pediatric-onset IBD who underwent endoscopy in both pediatric and adult settings. Participants reported on procedure-related satisfaction, pain, discomfort, anxiety, and preparedness. Regression analyses identified predictors of these outcomes, and free-text responses were analyzed using qualitative content analysis. Results Among 97 participants (72% female; median diagnosis age 14 years), deep sedation was more common in pediatric (95%) than adult endoscopy (57%). Paired Wilcoxon signed-rank tests showed adult endoscopy was associated with lower satisfaction with sedation (P = .0001), greater pain (P = .0007), and discomfort (P = .0002). There were no significant differences in anxiety (P = .47) or satisfaction with preparedness for adult care (P = .47). Older age at diagnosis was associated with lower odds of reporting pain (aOR 0.19, 95% CI 0.05-0.70) and anxiety (aOR 0.20, 95% CI 0.05-0.72) during adult endoscopy. Qualitative themes highlighted limited communication and perceived lack of empathy as barriers, while education and provider compassion facilitated positive experiences. Conclusions Endoscopy experiences differ between pediatric and adult care. Improving communication, patient education, and shared decision-making around sedation may improve endoscopy experiences in adult settings.