EGD + Colonoscopy Prep — Under 15 kg [Under 33 lb]

Lactulose option (oral)

← Other weight bands

Procedure Location

Surgery Center of Carmel

12188-A N Meridian St #150, Carmel, IN 46032

Surgery Center phone: (317) 569-8250

Arrive 1 hour before your scheduled procedure

🔎 What Are These Procedures?

Your child is scheduled for two procedures done back-to-back while asleep under anesthesia:

EGD (upper endoscopy) — a thin camera is passed through the mouth to look at the esophagus, stomach, and the first part of the small intestine. Small biopsies are usually taken.
Colonoscopy — the same kind of camera is passed through the bottom to look at the large intestine. Biopsies are usually taken here too.

Both procedures together take about 30–60 minutes. Your child will not feel anything.

📖 About the Bowel Prep

The colon must be clean for the doctor to see clearly during the colonoscopy. The medicines below empty it over the day before. The EGD itself does not need bowel prep — only the fasting times.

For infants and children under 15 kg only

This page describes the oral lactulose prep dosed by weight. If your child cannot tolerate oral lactulose, ask the office about the MiraLAX option or the clear-liquids + saline-enema option.

✅ Plan Ahead — pick up from the pharmacy

Lactulose oral solution (10 g per 15 mL) — prescription required; see dose table below.
Pedialyte® or clear apple juice (for extra fluids and mixing if needed).
Protective ointment (A&D, Desitin®, or Vaseline®) for the diaper area.

⚠️ 💊 Medications

Prepare a list of medications and be ready to discuss them with the nurse or scheduler when they call.
Stop iron, anti-diarrhea medicine 7 days before.
You can verify what medications may need to be stopped at meds.giready.com.

⚖️ Lactulose Dose by Weight

Your Child's Weight	Lactulose Dose	How to Give
Under 5 kg (under 11 lb)	5 mL (one teaspoon)	Give by mouth using a syringe; may mix into a small amount of juice or Pedialyte.
5–9 kg (11–20 lb)	10 mL (two teaspoons)	Give by mouth using a syringe or medicine cup; may mix into 2–4 oz of juice or Pedialyte.
10–15 kg (22–33 lb)	15 mL (one tablespoon)	Give by mouth; may mix into 4–6 oz of juice or Pedialyte.

Lactulose is naturally sweet. Most children accept it well plain or mixed into juice or Pedialyte.

If your child has trouble taking it all at once, offer it in small sips over 1–2 hours.

⚠️ Lactulose may cause gas and bloating — this is normal. Contact the office if symptoms are severe.

📅 3 Days and 2 Days Before the Procedure

Continue your child's normal diet.
Give one lactulose dose per day (see dose table above).

📅 Day Before the Procedure

Low-residue foods — until 6:00 PM

AVOID	OK to eat
Baby cereal with whole grains, oats, or added fiber	Plain white rice or white rice cereal
Raw or dried fruits and vegetables	Plain pasta (no chunky sauce)
Beans, peas, lentils	White bread or crackers
Nuts, seeds, popcorn	Strained baby foods (no skins, seeds, chunks)
Chunky table foods, meats with gristle	Plain yogurt (no fruit pieces or granola); scrambled eggs

Liquids — with these specific cutoffs

AVOID	OK to drink
Solid foods after 6:00 PM	Formula (until 10:00 PM)
Formula after 10:00 PM	Breast milk (until 2:00 AM day of procedure)
Breast milk after 2:00 AM (day of procedure)	Pedialyte®; clear apple juice (no pulp); water
Anything red or purple (looks like blood)	Clear broth (chicken or vegetable, strained); popsicles or plain gelatin (no red/purple)

Apply protective ointment to the diaper area.

⏱ Fasting Rules — Day of Procedure

These times are counted backward from your child's scheduled procedure time. The fasting rules apply to both the EGD and the colonoscopy.

What	When to Stop
All solid and low-residue foods	6:00 PM the day before
Formula	10:00 PM the day before
Breast milk	2:00 AM the day of procedure
Clear liquids (Pedialyte, water, clear juice)	2 hours before procedure time

⚠️ After the clear-liquid cutoff, no food or drink. This keeps your child safe during anesthesia.

⚠️ When to Call the Doctor

Your child won't drink, or has dehydration signs: no tears, dry mouth, or no wet diapers for 6+ hours.
Vomiting that prevents your child from keeping liquids down.
Fever, bloody stools, or severe belly pain.
You are unsure whether the prep is working.
You have questions about your child's medications.

Call (317) 338-9450 with any of the concerns above.

💡 Tips for Success

Offer clear liquids frequently in small amounts — a syringe, sippy cup, or bottle may help.
Popsicles and gelatin help keep your child hydrated. Avoid red and purple — they can look like blood.
Expect frequent watery stools — this means the prep is working.
Keep the diaper area well protected with ointment to prevent irritation.
Lactulose may cause more gas than MiraLAX — gentle tummy massage and bicycle legs can help.

Helpful Resources

▶ Watch a video about the procedure Example only — follow this handout, not the video. 📨 Patient portal Message us — preferred contact method 🌐 GIKids.org General info on pediatric GI procedures