preparing for colonoscopy

• Provide only clear liquids (no red liquids) starting the morning before your procedure.
• Your child may have small amounts of gummy bears, gummy worms and fruit snacks or fruit roll-ups (no red ones). These need to be stopped at midnight the night before the procedure.
• Start the bowel preparation – This is required for the procedure to be completed safely. Details under the “how will my child do a bowel preparation” section.
• The surgery department will call you with the time of the procedure, arrival time and final cut off time for drinking or anything by mouth.

These are clear liquids:

• Juice without pulp (apple or white grape)
• Jell-O®, Kool-Aid®, Gatorade®
• Non-cola pop (Sprite®, 7UP®, ginger ale)
• Popsicles
• Small amounts of gummy bears, gummy worms and fruit snacks or fruit roll-ups (no red ones). These need to be stopped at midnight before the procedure.
• Chicken or beef broth
• Do not give red drinks, popsicles, or Jell-O.

These are not clear liquids and should not be given starting the morning before your procedure:

• Orange juice
• Banana juice
• Pineapple juice
• Grapefruit juice
• Purple grape juice
• Milk
• Pediasure®
• Formula

• Your child will need to take medication(s) to clean out his/her intestinal tract.
• A prescription for the medications will be sent to your pharmacy of choice upon request.>
• The medications can be purchased over the counter in the laxative aisle at your local drug stores if your insurance does not cover them.
• Following the preparation instructions is very important to provide your child with safe, thorough testing. Failing to complete the preparation as recommended may result in needing to cancel/repeat the test.
• The goal of the bowel preparation is to have liquid stool that is a clear/cloudy colored, with no solid pieces.

Your provider will decide what the appropriate amount of medication will be for your child, but these are general bowel preparation guidelines:

1-2 years of age: 

• Mix 2.5 capfuls Miralax in 16 ounces clear liquid (no red). Drink it all over 4-8 hours.
• Give ½ chocolate laxative square (like Ex-Lax) in morning, and ½ chocolate square in evening.
  • If your insurance does not cover these, pharmacy can provide you a liquid version.
•  If your child is not having clear stools at end of prescribed bowel prep, give 1 capful Miralax in 8 ounces every hour (up to a total of 2.5 additional capfuls until your child has clear stool).

3-4 years of age:

• Mix 4 capfuls Miralax in 20 ounces of clear fluid (no red). Drink it all over 4-8 hours.
• Give 1 chocolate laxative square (like Ex-Lax) in morning, and 1 chocolate square in afternoon. 
  • If your insurance does not cover these, pharmacy can provide you a liquid version.
• If your child is not having clear stools at end of prescribed bowel prep, give 1 capful Miralax in 8 ounces every hour (up to a total of 4 additional capfuls until your child has clear stool).

5-9 years of age:

• Starting at 10:00 am, mix 7 capfuls Miralax in 32 ounces of a clear liquid (no red). Drink it all over 3-5 hours.
• Also at 10:00 am, give 1 Dulcolax (bisacodyl) 5 mg tablet. Repeat 4 hours later at 2:00 pm. May be given by mouth or by rectum as ordered by your doctor.
• If your child is not having clear stools at end of prescribed bowel prep, give 1 capful Miralax in 8 ounces every hour (up to a total of 7 additional capfuls until your child has clear stool).

10+ years of age: 

• Starting at 10:00 am, mix 14 capfuls Miralax in 64 ounces of a clear liquid (no red). Drink it all over 3-5 hours. 
• Also at 10:00 am. give 2 Dulcolax (bisacodyl) 5 mg tablets. Repeat 4 hours later at 2:00 pm. 
• If your child is not having clear stools at end of prescribed bowel prep, give 1 capful Miralax in 8 ounces every hour (up to a total of 14 additional capfuls until your child has clear stool).

if your child throw up or vomits any of the cleanout medications:

• Please wait 1 hour and try to restart it.
• If your child continues to throw up or other problems occur, call the GI procedure nurses at 937-641-4013 by 4:30 pm Monday through Friday.
• If after office hours, call 937-641-3000 and ask for the GI doctor on call for further instructions.

Plan on being at the hospital for about five hours after the time you arrive. The surgery center is on the second floor at Dayton Children’s main campus.
Before the procedure:

• You will meet with the anesthesiologist and discuss their plan for your child.
• You are allowed to stay with your child until they are brought back to the procedure room.

After the procedure:

• The GI doctor will come out to talk with you.
• Your child will go the recovery room for about 30-60 minutes. You will be brought back to the recovery room for your child to finish waking up with you by their side.
• After your child is awake and able to drink fluids, you will be given instructions for going home.

• You will be contacted with results typically within 7 working days.
• If you have not heard from our office after 7 working days, please call our office for results and provider recommendations.
• Follow-up appointments will be scheduled after the doctor reviews your child’s test results.

• Severe stomach pain that cannot be relieved or is different from why we are seeing your child.
• Fever over 101 degrees.
• Vomits blood greater than a teaspoon.
• Passes blood clots or has more than 1 teaspoon of blood coming from the rectum.
• If any of the above occur, call your GI doctor Monday through Friday, call 937-641-4013 during office hours 8:00 am to 4:30 pm.
• After office hours, weekends or holidays, call 937-641-3000 and ask to speak to the GI doctor on call.
• If you feel it is an emergency, call 911 or go to the emergency department.

• A colonoscopy is a procedure that allows the GI doctor (gastroenterologist) to look at the lining of the last part of the small intestine and the entire large intestine.
• The doctor puts an endoscope (a long, thin tube with a light and camera) into the rectum to see the intestine lining and take tissue samples (biopsies).
• Biopsies check for irritation, inflammation or possible infection that are causing your child to have the symptoms they are having.

• Your child will be under anesthesia (asleep) with medicine during the procedure and will not feel the endoscope or tissue samples being taken. This procedure is usually well tolerated.
• Afterward, your child may have some extra gas, because air is used to open the intestinal tract so the doctor can see the intestines while doing the scope. This gas can cause bowel cramps after the procedure. Walking around will help your child to pass the gas.
• There may be some streaks of blood in your child’s bowel movements for 1 day.

• There is a risk your child may have a reaction to the anesthesia or sedation medications, such as rashes, hives, or become agitated. Although rare, you should tell your doctor of any allergic reactions to medicines in the past. It is important to notify the gastroenterology department if there is a family history of problems with anesthesia.
• There is also a risk of aspirating (getting stomach contents into the lungs) when your child is sedated. You will receive a phone call the day before the procedure with instructions on when to stop food and drinks to decrease the chance of this happening.
• Bleeding may occur where tissue samples have been taken. The bleeding is usually a very small amount, but if there is a larger amount of bleeding then a blood transfusion could be needed. Notify the gastroenterology office if your child has a history of easily bruising or bleeding, or there is a family member with a bleeding disorder.
• The most serious risk or complication is perforation or causing a hole in the lining of the GI tract. This is a very rare but serious problem that could require being admitted to the hospital or possible surgery to repair.
• You will be asked to sign a consent form stating you understand the risks and benefits to the procedure before the exam.

It is important to us that you understand the reason for this procedure and have all your questions answered. Call the GI procedure nurses at 937-641-4013 during office hours (8:00 am to 4:30 pm Monday through Friday).

• If you reach our voicemail, please leave a message and your call will be returned within 24 hours.
• If you need to cancel a scheduled procedure, please call 48 hours before your appointment to allow another patient to be scheduled.