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What is a colonoscopy?

Colonoscopy is a test in which the gastroenterologist looks directly at the lining of the lower intestine (called “colon” or “large intestine”) with a narrow flexible tube mounted with a camera and light. This lubricated instrument is inserted into the sedated patient via the anus and can travel to just above the colon, into the lowest part of the small intestine. Tiny tissue samples (biopsies) are usually taken during the examination, and the doctor can also remove growths (polyps) using the scope.

Why might a child need a colonoscopy?

The most common conditions leading to colonoscopy in children are: blood in the stool, diarrhea of unknown cause, abdominal pain that might be due to intestinal inflammation, follow-up of a chronic condition involving the lining of the intestine.

What happens before and after the test?

In the days right before the test, your child will need to take oral medicine to flush out all the stool, and will also need to drink lots of clear fluids. It is important that during this time he/she does not eat any solid food or drink any liquids that you can’t see through. For 2 or more hours right before the colonoscopy, your child cannot have anything to eat or drink, as this would make it less safe to have the sedation/anesthesia (sleeping medication) needed for the test. You will be given more detailed instructions on all of the above by your child’s doctor or nurse.

NPO (Nil Per Os = Nothing by mouth) Guidelines for elective procedures with sedation

  • Clear Liquids - stop 2 hours before procedure
  • Breast Milk - stop 4 hours before procedure
  • Formula and Fortified Breast Milk
    • Children over the age of 12 months must stop formula at midnight before procedure
    • Infants < 1 year - stop 6 hours before procedure
  • Solid foods including candy, gum, non-human milk like (cow/soy), thickened formulas including commercial ones such as AR (added rice) - stop at midnight the day before procedure
  • Gastrostomy Tube (G-tube) formula feeding - should be stopped after midnight except for children under 1 year of age who may continue g-tube formula up to 6 hours prior to the time of surgery/procedure/sedation.
  • Clear liquids include water, apple juice, Pedialyte. No carbonated beverages should be consumed after midnight.

After the test, the doctor will tell you what was seen with the scope, and may have pictures of your child’s intestine to show you. You will get biopsy results later. Once your child is awake and drinking liquids, he/she can go home and start eating as before. A few children feel sick after the test and may be watched a little longer until they feel better.

What are the risks of colonoscopy?

Colonoscopy is a safe procedure, but does have some small risks. In general these are: a hole made in the intestinal wall, excessive bleeding, problems from the sleeping medications given for tests, or infections.

Your gastroenterologist will go over these and any other risks related to your own child’s situation.

What should we watch for after the colonoscopy?

Your child may have a little blood in the stool for a day or so, and this is ok. There may be discomfort from gas in the intestine left over from the test, which will pass with time, as the child lets it out. However, if your child has any of the following, you should call your doctor or go to the emergency department: abdominal pain for more than an hour, an abdomen that is big and hard, bleeding more than about a spoonful, bleeding that continues beyond the second day, fever, or repeated throwing up.