EGD + Colonoscopy Prep
21–30 kg[46–66 lb]
Lactulose option (oral)
← Other weight bands
Procedure Location
Surgery Center of Carmel
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.
✅ Plan Ahead (buy at least 2 days before)
Buy these items at least 2 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. |
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 |
⚠️ 💊 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.
⚠️ 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.
📅 3 Days Before — Low-Residue Diet
| AVOID |
OK to eat |
| Whole grains, nuts, seeds |
White rice, pasta, potatoes (no skin) |
| Raw fruits and vegetables |
Bananas, melons, cooked veggies |
| Corn, beans, popcorn |
Eggs, chicken, fish, yogurt, pudding |
📅 2 Days Before the Procedure
At bedtime
Give Dulcolax tablets — 1 tablet (5 mg) — with a sip of water.
Evening — prepare the prep
Prepare only — do NOT drink yet. Mix lactulose into Gatorade and refrigerate overnight:
- 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 — Low-Residue Through Lunch
After 2:00 PM — clear liquids only.
| AVOID |
OK to eat / drink |
| RED or PURPLE drinks or foods |
Water, apple juice, white grape juice |
| Dairy (milk, yogurt, ice cream); juices with pulp |
Lemonade, clear soda, clear broth |
| Any solid food |
Popsicles, plain Jell-O, tea/coffee without milk |
🥤 THE BIG PREP — afternoon / evening
Best to start right after school — don't delay too long, or your child may not finish before bedtime.
3:00 PM
Give Dulcolax tablets — 1 tablet (5 mg) — with a sip of water.
3:00 PM
Start the lactulose solution — the pre-mixed lactulose + Gatorade from the fridge (see the dose-by-weight table above for the amount).
Have your child drink 5 oz (~150 mL) every 30 minutes until finished.
💡 Tips for drinking the lactulose prep
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.
⚠️ Rescue plan
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 2 hours before the procedure.
📅 Day of Procedure
- Clear liquids only after 2 PM the day before. No solid food.
- Keep your child well-hydrated — offer small sips of clear liquids every 30–60 minutes through the prep day. Each drink: no more than 5 oz (~150 mL). Frequent small drinks beat occasional large ones — better hydration, easier on the stomach.
- Stop all clear liquids 2 hours before the procedure.
- 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.
⚠️ If the bowel prep is not followed exactly, the colonoscopy may be delayed or canceled. The EGD does not need bowel prep, but the fasting rules apply to both.
Helpful Resources
🍚 Low-Residue Diet — Sample Meals
Meal ideas for the low-residue (“white”) diet. Continue this diet for the 3 days before the procedure, through lunch the day before. After 2:00 PM the day before, switch to clear liquids only — no dairy.
Breakfast (morning)
- Scrambled eggs
- White toast with butter
- Banana
- Yogurt (no seeds or berries)
- Apple juice
Lunch (~noon)
- Plain chicken sandwich on white bread (no veggies)
- Mac and cheese
- White rice with chicken
- Plain pasta
- Applesauce
- Vanilla pudding
After lunch (~2:00 PM onward)
- Clear liquids only (see allowed drinks above)
- No more dairy — milk, yogurt, ice cream, etc.
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
