Kids Health Info

FACT SHEET

Colonoscopy
How you say it: Colonoscopy: Coal-on-osk-o-pee Gastroenterologist:Gas-tro-ent-er-olo-jist Gastrointestinal tract: Gas-tro-in-tes-t-nal tract or G.I. tract Biopsy: Bye-op-see

Colonoscopy is a procedure in which a gastroenterologist (specialist doctor)looks at the inside of the large bowel (colon) using a a special camera called an endoscope. A colonoscope is a long flexible tube that has a light and a camera on the end. The colonoscope is inserted into the bottom (anus) and then slowly advancedalong the large bowel. The bowel is carefully examined and small samples of bowel tissue (biopsies) are taken for further tests. The main reasons children need a colonoscopy are to find a cause for abdominal pain, diarrhoea and bleeding from the bowel.Children may need to be admitted the night before the procedure so that the bowel can be washed out, but can usually go home within a few hours of the colonoscopy.

Preparing for a colonoscopy

Before having a colonoscopy, the bowel needs to be completely empty . To make sure this happens your child must follow these directions:

One week before:

Stop taking medications that have iron in them.

Four days before:

Stop eating foods that have small seeds or pips in them, such as wholegrain bread, tomato, cucumber and nuts.

The day before:

All solid foods must be finished by 2PM. Your child can drink anything they like until 4PM - ie water, milk or juice. After 4PM your child may only drink clear fluids (such as water or cordial). * Clear fluids are drinks you can easily see through, including, water, apple juice, lemonade, cordial, jelly (not red or green), lemonade icy poles, weak black tea or coffee. Clear fluids do NOT include fresh fruit juice and milk.

The Royal Children's Hospital Melbourne www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=7847

29 May 2012 p1/3

Kids Health Info Colonoscopy

FACT SHEET

Bowel washout
Most children need to have a special drink called a "bowel washout" the evening before a colonoscopy. This drink is very important as it empties the bowel, helping the doctor to see more clearly. If your child cannot drink the bowel washout at home, they may need to stay in hospital the night before the colonoscopy so that the bowel washout can be given through a nasogastric tube. A nasogastric tube is a small thin tube, which is insertedthrough the nose and then passed down into the stomach. The bowel washout is then given through this tube over 4-6 hours. Your child may feel very fulland mayvomit. Theywill have diarrhoea for several hours.
On the day:
All children having a colonoscopy are given a general anaesthetic. This is a medicine that makes them have a special sleep so they don't see, feel or hear anything while the doctor examines them. To find out more about anaesthetics,visit the Anaesthetic Departmentweb page. Your child must follow hospital fasting instructions, or the procedure may be postponed and you will need to book a new appointment. Your doctor or nurse should give you the fasting instructions, or you can get them from the Anaesthetic Departmentweb page. Most medications can be taken as usual. Please talk to your child's doctor about this before the colonoscopy.

Side effects
Sometimes your child may have one or more of the following side effects after the colonoscopy. These usually get better without any special treatment. Nausea or vomiting: If your child feels sick, stop them eating and drinking for half an hour, after this they can start having sips of clear fluids. You can increase what they eat and drink slowly. Abdominal (tummy) pain and bloating: If the pain is mild, rest and have sips of clear fluids until feeling better. Sore throat: Sucking throat lozenges or sipping warm fluids can help. Bleeding: A small amount of blood might be seen in bowel actions (poo). This is usually from the biopsies (small samples of tissue) that were taken.

Care after a colonoscopy

After the colonoscopy, your child can start to eat a light diet (for examplejelly, soup, pasta, toast). They may return to their usual diet when they feel well enough. Babies can start breast-feeding, or drinking formula or water when they are awake. Children should have a quiet time following the colonoscopy, but should be able to return to their normal activities the next day. Young adults must not drive a car, operate machinery or make important decisions for the rest of the day (because of the anaesthetic). Children can usually go home on the same day as the colonoscopy. A responsible adult (over 18 years old) must go home with them. A nurse will give the responsible adult an instruction sheet, explaining the care needed after a colonoscopy. Please read the fact sheet -Care after gastrocopy or colonoscopy.

The Royal Children's Hospital Melbourne www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=7847

29 May 2012 p2/3

Kids Health Info Colonoscopy

FACT SHEET

When to come back

Call the RCH switchboard on (03) 9345 5522 and ask to page the 'Gastroenterology Registrar' or your Gastroenterologist if your child has: Vomited more than 2-3 times. Vomit with more than 2-3ml (1/2 teaspoon) of bright red blood in it. Bowel actions (poo) with more than the expected amount of blood. Severe tummy pain or bloating. A high temperature (above 38 degrees Celsius). Difficulty swallowing. Come back for your follow up appointment as directed by your Gastroenterologist.

Key points to remember

The full amount of the bowel washout (drink) must be taken for the colonoscopy to be successful. Let the Gastroenterology Nurse Coordinator (RCH tel (03) 9345 5060) know if your child is unwell before the colonoscopy, eg, if they have a chest infection or a bad cold. Colonoscopy is a very safe procedure and complications are uncommon. Your doctor will discuss any possible complications with you.

For moreinformation
Factsheet:Having a colonoscopy 'Having a colonoscopy' pamphlet (Ask for this from the Gastroenterology department). Talk to the RCH Gastroenterology Nurse Coordinator. T: (03) 9345 5082. RCH Day Surgery (tour, video, information brochure). T: (03) 9345 6570. Anaesthetic information booklet "I'm going to have an anaesthetic" (please contact the anaesthetic department for this).

Individual instructions
The name of your child's Gastroenterologist is: Dr __________________________
This factsheet was developed in consultation with the RCH Department of Gastroenterology, Day Surgery Nursing and the Department of Anaesthetics.First published Feb 2005. Updated November 2010.

The Royal Children's Hospital Melbourne www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=7847

29 May 2012 p3/3