EGD + Colonoscopy Prep
🔎 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.
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.
⚠️ 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, 2 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 |
|---|---|---|
| 15–17 kg (33–37 lb) | 60 mL | 20 oz (~600 mL) |
| 18–20 kg (38–44 lb) | 75 mL | 20 oz (~600 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 — brand-name shortcuts can lead to the wrong product.
| 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. |
150 mL bottle enough for big prep with rescue |
| Bisacodyl 5 mg tablets (Dulcolax Tablets — Overnight Laxative) ⚠️ NOT Dulcolax liquid or soft-chews |
1 Dulcolax 5 mg tablet (5 mg total) |
| Gatorade or Powerade (any color except red or purple) — for mixing with the lactulose | At least 32 oz |
| Skin protection — protective ointment (Desitin or Vaseline) for anal-area comfort | 1 tube |
📅 1 Day Before — Diet & Bowel Prep
The busiest day, in two parts: first 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 (see the table). No red meat, no raw vegetables, no whole grains, no nuts or seeds.
| ✅ OK to eat (breakfast & lunch) | ❌ Avoid |
|---|---|
| White bread, plain bagel, white rice, plain pasta | Whole grains, brown rice, whole-wheat bread |
| Eggs (scrambled, fried, boiled) | Raw fruits and vegetables |
| Chicken breast, turkey, fish (baked or grilled — not fried) | Corn, beans, peas, lentils, popcorn |
| Mac & cheese, plain mashed potatoes (no skin) | Nuts, seeds, granola |
| Banana, applesauce, melon | Fried or greasy foods (fries, pizza, burgers) |
| Plain yogurt, pudding, Jell-O | Red meat (steak, ground beef) |
| White crackers, pretzels | Salad, raw veggies, broccoli, leafy greens |
Breakfast: scrambled eggs + white toast with butter · pancakes or waffles (plain or with syrup — no nuts, no whole wheat) · plain bagel with cream cheese + banana
Lunch: grilled chicken sandwich on white bread (no lettuce or tomato) · mac & cheese + applesauce · white rice + baked chicken or fish + banana
After 2:00 PM — Clear Liquids Only
No more solid food. No dairy — no milk, yogurt, or ice cream.
| ✅ OK to drink | ❌ Avoid |
|---|---|
| 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 3 oz (~90 mL) every 30 minutes until finished.
Drink each cup fast (don't sip slowly — quick drinking helps the stomach empty and reduces nausea). Cold is easier — that's why we refrigerated it overnight. 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 30 mL more lactulose in 8 oz of Gatorade.
- Morning of procedure: give 15 mL more lactulose in 4 oz of Gatorade, at least 2 hours before the procedure.
📅 Day of Procedure
- Clear liquids are allowed up until 2 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 3 oz (~90 mL).
- Bring comfort items for your child (toy, blanket, tablet, etc.).
- The EGD is done first (through the mouth), then the colonoscopy. Both happen during the same nap.
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.
Call (317) 338-9450 if your child has any of the following after the procedure:
- A temperature over 101°F (38.3°C)
- Stool that is black or has more than a small streak of blood
- Severe or worsening abdominal pain, or a hard, swollen belly
- Persistent vomiting, or refusal to drink
- Difficulty breathing or chest pain — this is an emergency, call 911