It is very important that you follow each step and complete all of these instructions or your child's colonoscopy may have to be repeated.


Conditions that call for colonoscopies on children include: 

  • Tummy (stomach) pain 
  • Changes in bowel movements or diarrhea 
  • Abnormal changes found on sigmoidoscopy 
  • Blood in the stool, or black, tarry stools 
  • Follow-up of a past finding, such as polyps or colon cancer


 PURCHASE IN ADVANCE

  • One 238 gm bottle of Miralax (PEG 3350 or Glycolax)-no prescription needed
  • One 36 ounce bottle of a sports drink (examples include Powerade, Gatorade, sugar-free Powerade, sugar-free Gatorade, Crystal Light, iced tea)or any clear electrolyte liquid-Recommended flavor lemon-lime
  • Please do not purchase red or purple sports drinks
  • Four Dulcolax (bisacodyl, 5 mg) is a laxative tablet or suppository that is available over the counter OR Ex-Lax chocolate square (Senna 8.6 mg), another laxative available over the counter.
  • All of these medications are available over the counter at your pharmacy, Walmart or any other grocery store


SEVEN DAYS BEFORE COLONOSCOPY

  • Avoid giving your child iron supplements. 
  • Most other medicines should be taken as usual, before colonoscopy day.


FOUR DAYS BEFORE COLONOSCOPY 

  • Avoid giving foods with tiny seeds or pips, such as whole-grain bread, tomatoes, cucumbers, or nuts. 


DAY BEFORE COLONOSCOPY

Diet Modifications

  • Your child may have a light breakfast followed by a liquid diet for the rest of the day and clear electrolyte liquids only in the evening
  • Please avoid all liquids that are red, orange, or purple as they will stain your bowel and impede visualization. Please avoid all dairy products.
  • A clear liquid diet may include:

Soup: Clear broths such as chicken, vegetable, beef consommé. These broths should not have noodles or solid food in them.

Juice: Apple, limeade, white cranberry, white grape, Pedialyte

Beverages: Soda, Gatorade (or other sports drinks), vitamin water(or other similar electrolyte drinks)

Desserts: Jello (no red or purple), Italian ices, popsicles, hard candies


Prep Instructions

  • Prepare the Miralax solution. Miralax comes with a measuring cap. One capful (17 gms) is measured up to the line inside the cap. Mix the Miralax in a room temperature liquid until fully dissolved THEN chill so it will be ready later in the day.
  • Mix 12 capfuls of Miralax in 36 ounces of liquid (Pedialyte or a Sports drink like blue of colorless Gatorade, or Powerade in a large pitcher. You may use any other clear liquid you choose as well. Stir. 
  • 12 NOON (the day before the procedure):
    • Take 2 Dulcolax tablets (you may crush the tablets if you have any difficulty in swallowing) or 2 chocolate Ex-lax square.
  • 2:00 p.m. (the day before the procedure):
    • Begin drinking the Miralax solution. Your child should finish the solution within 3-4 hours.
    • Expect to move your bowels at least 5-10 times, although some people do not have multiple bowel movements after this initial dose of the preparation. It usually takes about 30-60 minutes after drinking the Miralax solution to begin having bowel movements.
    • You may notice some bloating or cramping at the beginning of the preparation, but this will usually improve once the bowel movements begin.
  • 6:00 p.m. (the day before the procedure):
    • Take 2 Dulcolax (tablet or suppository) or 2 Ex-lax square
  • 9:00 p.m. (the day before the procedure):

    If the stools are watery, clear, greenish/yellowish, you may continue to drink clear electrolyte liquids until midnight. 

  • Your child may have a light meal up to 6 hours before the test and clear liquids up to 4 hours before the test. 


HOW DO I KNOW IF YOUR CHILD PREP IS ADEQUATE?

The stool should be watery in consistency and should be a clear, yellow-tinged fluid without stool particles. Digestive secretions will continue to “tint” the stool yellow. If you are concerned that there are still brown stool particles and pieces noted please call the GI person on call for further instructions. If your prep is inadequate, the physician may not be able to visualize the entire colon adequately.


Things that you need to know before you go to the facility

  • Make sure you know the address of the facility where your child's procedure will be performed.
  • Please arrive 1 hour in advance of your scheduled procedure time to allow time to complete the necessary paperwork.
  • Please bring a photo ID.
  • Please bring a current insurance card, if applicable.
  • If for any reason you need to cancel your procedure, please call your doctor at the number provided to you. You must call at least 48 hours in advance to allow other patients to be scheduled for procedures.


After Colonoscopy Procedure 

  • It takes about an hour to begin to recover from the sedative. 
  • Your child may experience slight bloating or pass gas for a few hours after the exam, as the air from your colon is cleared. Walking may help relieve any discomfort. 
  • You may also notice a small amount of blood with the first bowel movement after the exam. Usually, this isn't cause for alarm. 
  • Consult your doctor if your child continues to pass blood or blood clots or if you have persistent abdominal pain or a fever of 100 F (37.8 C) or higher.