What is a colonoscopy?
A colonoscopy is a test where a doctor uses a camera to look inside your child’s bowel. They do this with an endoscope, which is a thin, flexible tube that has a light and camera. A doctor will put the endoscope into your child’s bottom. This lets them see the colon (the large intestine), and sometimes into the end of the small intestine (the terminal ileum). This helps check for any problems and allows them to make a diagnosis.
The test, including the anaesthetic, lasts about 60-90 minutes. Sometimes, the test includes an upper GI endoscopy. This checks the gullet, stomach, and upper small bowel, so it may take a bit longer.
Why does my child need a colonoscopy?
Your child needs this test to confirm or rule out particular diagnoses. Your child’s doctor should have discussed the specific reason for this colonoscopy.
What are the risks of the colonoscopy?
It is common to have spots of blood in the poo after the colonoscopy, and this usually resolves within a day or so. A large bleed is very rare, but if this does happen then your child would need to stay or return to hospital.
The most serious risk bowel is a perforation (making a hole in the bowel). This is very rare and occurs in approximately 1:1000 colonoscopies. If this happened, your child would need to stay in hospital and may need another operation to close the hole.
Leading up to the colonoscopy
You should have received an admission letter with the date and time of the procedure. The admission letter will have a contact number for the scheduling team on it. Please call this number right away to confirm or reschedule the operation date. You can also contact this number if you have any questions before the surgery.
There are essential steps to prepare for the colonoscopy. This includes taking a laxative medication called bowel preparation.
What is bowel preparation?
Bowel preparation is a laxative medication which will make your child poo so the bowel is completely empty and ready for the test. Bowel preparation can be unpleasant, but it is important to enable the doctor to see the bowel lining. If the bowel preparation isn’t done correctly, the procedure could be abandoned. It will then need to be repeated at a later date.
Points to consider before taking your bowel preparation:
- Continue to take regular medication but avoid taking within one hour of bowel preparation.
- Do not eat any food for at least two hours before taking the bowel preparation.
- It may be better to keep your child off of school the day before the colonoscopy. This is because your child will need access to a toilet at all times.
- Diarrhoea is normal and means that the medication is working. Make sure your child drinks lots of clear fluids to prevent dehydration.
- Side effects of bowel prep include nausea, vomiting, bloating, abdominal pain, irritation around the bottom and sleep disturbance.
- Please seek urgent medical attention if there are any signs of allergic reactions. These include a rash, itchy skin, redness and swelling.
Making up the bowel preparation:
Always dissolve the full sachet in 100 ml of water. You may swap the water with another drink.
The mixture will fizz and become slightly warm.
It is best to drink the whole solution as quickly as possible.
Your child may not need to drink the whole 100 ml. For example, if you were told to give half a sachet, your child would only need to drink 50 ml of the mixture.
Please ensure you open a new sachet for each dose of bowel prep.
| Prescription | Step 1 | Step 2 | Step 3 |
|---|---|---|---|
| 1 sachet | Mix a whole sachet with 100 ml of water | Drink the whole 100ml solution | |
| Half a sachet | Mix a whole sachet with 100 ml of water | ONLY drink 50 ml of the mixture | Discard the remaining mixture |
| A quarter of a sachet | Mix a whole sachet with 100 ml of water | ONLY drink 25 ml of the mixture | Discard the remaining mixture |
Preparing for a colonoscopy
Here are key instructions to follow in the week before your child’s procedure. This includes advice about diet, medications, and bowel preparation. If you don’t follow these instructions, we may have to reschedule your child’s colonoscopy.
Seven days before the colonoscopy (Date: ……………………)
Stop taking any iron supplements, for example Sytron.
Two days before the colonoscopy (Date: ……………………)
TWO DAYS BEFORE THE COLONOSCOPY
The day before the colonoscopy (Date: ……………………)
Your child needs to follow a liquid diet for most of the day before the colonoscopy. This helps ensure the bowel is clear for the procedure. Please see below for detailed instructions. Please remember no solid food or milk should be taken after the bowel prep has been started.
If your child is on the morning operating list:
- Please make sure your child eats breakfast by 07:30 am the day before the colonoscopy.
- Your child must follow the liquid diet as below after the first dose of the bowel prep has been taken. Please avoid food, milk and pure fruit juice.
- After breakfast, give the first dose of medicine.
09:00 -10:00am – 1st dose (…….. sachet)
3:00 – 4:00pm – 2nd dose (…….. sachet) - From 2:30am on the morning of the colonoscopy the child is only allowed water, diluted squash or dioralyte until they arrive on the ward – no fizzy drinks.
DAY BEFORE
After 07:30 am breakfast the day before the colonoscopy
09:00-10:00 am – 1st dose of the bowel prep (…….. sachet)
Continue with the liquid diet
15:00-16:00 pm – 2nd dose of the bowel prep (…….. sachet)
Continue with the liquid diet
ON THE DAY
From 02:30 am on the morning of the colonoscopy until you arrive on the ward
On the day of the colonoscopy
Your child must not have anything to eat on the day of their colonoscopy. They can drink diluted squash or water until they arrive on the ward – no fizzy drinks.
Immediately after the colonoscopy?
Your child can eat and drink as soon as they are awake and able to sit up on their own. The nurses on the ward will arrange any medicines for home and give you the relevant contact details.
How long will it take to get the results of the test?
Before you leave the hospital, the doctor will meet with you and your child. They will explain the findings and begin any treatment if needed.
If we have taken biopsies, then it can take a few weeks to get results from the lab. We will set up an outpatient appointment to talk about the results once they are ready.
We may need to start your child on a new treatment before the appointment. If that happens, we will reach out to you and your GP to explain.
Advice after the colonoscopy
Pain
Some children feel tummy discomfort and are more gassy after a colonoscopy. This usually settles on its own. Mild pain relief like paracetamol (Calpol, Disprol) can help.
Vomiting
Vomiting is common after general anaesthesia. If your child is vomiting a lot, they might need a longer stay in hospital for observation. Sometimes, they may need to stay overnight. If your child is sick whilst at home, offer them small amounts of weak juice. If the vomiting continues, then please contact your GP or the hospital.
Bleeding
After the colonoscopy, you or your child might see some blood streaks in the stool. This usually stops on its own. If your child has a significant amount of blood loss in their poo then you should contact the ward.
School
General anaesthetics can make your child feel dizzy as they wear off. Please watch your child carefully for the first day at home. If your child is comfortable, they should return to school the next day.
Problems
If you have any worries, please contact your GP or the ward where your child was admitted.
Back to topIf you have questions or need more help, please call ward 49 at Leeds General Infirmary on 0113 392 7449