Colonoscopy Bowel Prep
📖 About the Procedure
A colonoscopy is a short procedure done under anesthesia. A pediatric gastroenterologist passes a thin, flexible camera through the bottom to look at the large intestine. Small biopsies are usually taken. The procedure itself takes about 20–45 minutes, but plan to be at the facility for several hours total. The colon must be clean for the camera to see well — that's what the medicines below are for.
Prepare a list of medications.
Stop iron, anti-diarrhea medicine 7 days before.
You can verify what medications need to be stopped at meds.giready.com.
⚠️ If any history or suspicion of constipation, please do a pre-cleanout before the regular prep timeline below:
15 mL of lactulose mixed into 4 oz of clear liquid, 3 times daily for 3 days — best done over the weekend before the procedure
Then continue prescribed daily laxatives, or at least 15 mL of lactulose daily, until the procedure.
⚖️ Big-Prep Mix — by Weight
This is the lactulose-in-Gatorade mix your child will drink on prep day. Find your child's weight and mix that amount:
| Your Child's Weight | Lactulose to Mix | Into Gatorade |
|---|---|---|
| 21–30 kg (46–66 lb) | 90 mL | 28 oz (~850 mL) |
Lactulose is naturally sweet. Most children accept it well mixed with Gatorade.
⚠️ Lactulose may cause gas and bloating — this is normal. Contact the office if symptoms are severe.
✅ Medications and Supplies needed
Pick up any prescription as soon as possible after scheduling. Buy all other supplies at least 5 days before the procedure. Check the active ingredient on the label.
| Active ingredient / Item | What to get |
|---|---|
| Lactulose oral solution (10 g per 15 mL) — prescription required Call the office if you have not received a prescription. |
180 mL bottle enough for big prep with rescue |
| Bisacodyl 5 mg tablets (Dulcolax Tablets — Overnight Laxative) ⚠️ NOT Dulcolax liquid or soft-chews |
2 Dulcolax 5 mg tablets (10 mg total) |
| Gatorade or Powerade (any color except red or purple) — for mixing with the lactulose | At least 45 oz |
| Skin protection — protective ointment (Desitin or Vaseline) for anal-area comfort | 1 tube |
📅 2 Days Before the Procedure
- 21–30 kg (46–66 lb): Mix 90 mL of lactulose into 28 oz (~850 mL) of Gatorade. Shake, refrigerate overnight.
If you forget the bedtime Dulcolax dose: on the day of prep, give 2 tablets (10 mg) with or just before the lactulose — that's the bedtime dose (1 tablet) added to the scheduled day-of dose (1 tablet). Don't skip — combine.
📅 1 Day Before — Diet & Bowel Prep
Two parts today: the diet below, then THE BIG PREP — the bowel-prep medicines — in the afternoon and evening.
The Diet — breakfast & lunch: Low-Residue (“White”) foods
Low-residue foods only — the table pairs meals that work with the ones to skip. Nothing with whole grains, red meat, nuts, seeds, popcorn or beans, and nothing fried or greasy. No vegetables that day except plain potato without the skin; fruit only if it is soft and peeled.
| ✅ OK to eat (breakfast & lunch) | ❌ Instead of |
|---|---|
| Scrambled eggs + white toast with butter | Whole-wheat toast, oatmeal with nuts or berries |
| Pancakes or waffles, plain or with syrup | Whole-grain waffles, berries, granola topping |
| Grilled chicken sandwich on white bread, no lettuce or tomato | Burger and fries, pizza, anything fried |
| Mac & cheese + applesauce | Salad, raw veggies, corn |
| White rice + baked chicken or fish + banana | Brown rice, beans, steak or ground beef |
| Snacks before 2 PM: plain yogurt, pudding, Jell-O, white crackers, pretzels, melon | Granola bars, popcorn, trail mix, fruit with the skin on |
After 2:00 PM — Clear Liquids Only
No more solid food. No dairy — no milk, yogurt, or ice cream.
| ✅ OK to drink | ❌ Skip that day |
|---|---|
| Water, apple juice, white grape juice | RED or PURPLE drinks or foods |
| Lemonade, clear soda, clear broth | Dairy (milk, yogurt, ice cream); juices with pulp |
| Popsicles, plain Jell-O, tea/coffee without milk | Any solid food |
🥤 THE BIG PREP — afternoon / evening
Best to start right after school — don't delay too long, or your child may not finish before bedtime.
Have your child drink 5 oz (~150 mL) every 30 minutes until finished.
Drink each cup fast (don't sip slowly — quick drinking helps the stomach empty and reduces nausea). If your child can't keep up, pause 30 minutes and resume. If your child vomits, wait 30 minutes and restart at a slower rate.
- Expect diarrhea — this is normal and means the prep is working. Stool will turn light-colored or yellow (tinted by the Gatorade) — that's the sign the colon is clearing.
- Keep giving clear liquids throughout the day.
Anonymous · about 1 minute
If stools are not clear or pale yellow 4 hours after starting (or if no stools), give extra lactulose:
- Evening: give 45 mL more lactulose in 12 oz of Gatorade.
- Morning of procedure: give 15 mL more lactulose in 5 oz of Gatorade, at least 3 hours before the procedure.
📅 Day of Procedure
- Clear liquids are allowed up until 3 hours before the procedure — nothing by mouth after that. No solid food the day of.
- Offer small sips of clear liquids every 30–60 minutes through the prep day. Each drink: no more than 5 oz (~150 mL).
- Bring comfort items for your child (toy, blanket, tablet, etc.).
Helpful Resources
After the procedure & when to call
- Your child will wake up in the recovery area. Some grogginess and gas/cramping/bloating are normal for several hours.
- A small amount of blood with the first stool after a colonoscopy can be normal, especially if biopsies were taken.
- An adult must stay with your child for 24 hours after anesthesia.
- Start with clear liquids, then advance to a regular diet as tolerated.
- No school, daycare, or sports for the rest of the day. Most children are back to normal activity the next day.
- The doctor will discuss what was seen before you go home. Biopsy results take about 1–2 weeks; we'll send the results to the portal and discuss over the phone or at the next appointment.
A sore throat, mild cramping and extra gas are common for about a day, and streaks of blood in the first stool or in vomit can be normal after biopsies. Call (317) 338-9450 if your child has:
- A temperature over 101°F (38.3°C)
- More than about a tablespoon of blood, in stool or in vomit, or stool that is black
- Severe or worsening abdominal pain — call us, and we will tell you whether to be seen
- Severe or persistent sore throat, drooling, or trouble swallowing
- Difficulty breathing or chest pain — this is an emergency, call 911
After hours, the same number reaches the provider on call.