EGD + Colonoscopy Prep — Under 15 kg [Under 33 lb]
🔎 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 clean the colon (empty it) over the day before. The EGD itself does not need bowel prep — only the fasting times.
✅ Medications and Supplies needed
- 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.
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 |
⚠️ 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.