Preparing for a paediatric endoscopy

Before you have your endoscopy you will need to make sure your digestive system is clear of food and poo. This is so the cameras can get the best pictures possible of your digestive tract and bowel lining. 

To do this you will be given some special medicine which makes you poo a lot, and you will need to stop eating on the day before you have your endoscopy.

Preparing your body ready for your endoscopy isn’t much fun, and takes quite a lot of time. Lots of people say it is the worst part of the whole procedure. However, it is really important to do the best you can to completely clear your bowels so the camera can get a great view of your entire bowel lining to see if there’s any inflammation or changes.

The bowel prep medicine

Bowel prep is the special medicine you will need to take the day before your endoscopy. These are laxative drinks which usually come as a powder which you mix with water. You will be given detailed instructions on how to make up this medicine, how much you need to drink, and when to drink it.

 Some of the commonly used brands of bowel prep are:

• Picolax
• Klean-prep
• Movi-prep

You’ll need to drink quite a lot of this mixture, as much as two litres, and some people don’t like how it tastes. It can help to mix in some fruit squash (not red or black coloured), chill the drink, and also drink it through a straw. 

Usually after two or three hours, the bowel prep drinks will make you do lots of watery poo, so it is best to stay close to a toilet. It can feel a bit worrying when this happens, but it is normal, and it means the bowel prep medicine is working. Once it is cleared out you will stop having the diarrhoea. Bowel prep works differently for everyone, however if you follow the instructions given to you by your IBD team, you will stop having diarrhoea well before the time you need to leave for your endoscopy.

You will probably need to take two days off school for your endoscopy. Because you will spend a lot of time on the toilet while you clear your bowels out you will probably need to take the day before the endoscopy off school, as well as the following day for the procedure. You should be able to return to school the day after.

Children over the age of six will usually take their bowel prep at home, and come into hospital on the day of their endoscopy. Younger children generally have their bowel prep in hospital. This is because they can become dehydrated, and the prep can make them sick.

If your bowel prep isn’t taken properly, or hasn’t worked, and there is still poo in the way, there may be parts of your bowel that can’t be checked properly. Good bowel preparation is important to make sure your endoscopy is as useful as possible.

If you are having a lot of trouble taking your bowel prep, there are other options available, such as laxative tablets, or even coming into hospital to take your bowel prep through a nasogastric (NG) tube. This is a special thin tube that can be put up your nose and into your stomach, meaning you can have the bowel prep medicine without having to drink it. You can speak to your IBD team if you are having problems drinking the prep.

Timeline for your paediatric endoscopy preparation

Before COVID-19 the preparation for an endoscopy started around a week before. However, it can now start two weeks before if you need to isolate. See the information about COVID-19 and endoscopies later in this course. Below is what the week before your endoscopy might look like. 

The timings of your preparations will be different depending on whether you have your endoscopy in the morning or in the afternoon. This is just an example of how you might prepare for your endoscopy - your IBD team will give you information and clear instructions on exactly what they need you to do. 

Seven days before

You may need to stop taking certain medicines, such as iron tablets or aspirin. Your IBD team will let you know what you need to stop taking.

Two days before

You may need to change the things you are eating and could be placed on a low residue diet. You won’t be able to eat things with lots of fibre in them such as cereals, wholemeal bread, salad, fruit, nuts and seeds. You also need to avoid eating or drinking anything red or black, such as jellies, lollies and squashes. These can stain your bowel lining and look like blood or inflammation on the endoscopy cameras.

The day before

1. You will need to stop eating food completely. You can drink clear drinks, clear soup (with no bits), eat jellies, lollies and some sweets (nothing red or black!) to help with this. It is really important you don’t eat anything else, so your bowel is completely clear. It’s also important you drink plenty of water so you don’t get dehydrated
2. You will need to start taking your bowel prep medicine. It should begin to work around two to three hours after you drink it, although sometimes it can take a bit longer. You will need to poo urgently and lots of times, so it’s best to stay close to a toilet. Your poo will be very watery and your tummy may feel a bit uncomfortable. Your IBD team will tell you when exactly to start drinking the medicine and how much of it you need to take. It is likely you will need to drink around two litres of the medicine throughout the day

The day of your endoscopy

You will need to drink water only. By now your bowels should be clear and ready to be examined.