Preps and Procedures

Colonoscopy Clean-out Instructions

24 hrs before the procedure

NO solid food. Only Clear liquids, ice pops or jello (no milk, orange juice or any shakes) We prefer Gatorade or any sport drinks (any color but NOT RED). If you are hungry take some marshmallows, that is the only solid food you will be allowed to have. ​

Miralax (Glycolax)/Dulcolax dosage amounts

Age

• 3-5y: 4 capfuls of Miralax or Glycolax in 32 ounces of Gatorade
• 6-11y: 6 capfuls of Miralax or Glycolax in 48 ounces of Gatorade
• ​12+y: 10 capfuls of Miralax or Glycolax in 80 ounces of Gatorade

Directions

At 12 Noon: Start drinking Miralax and finish by 6 pm. 

​

Take the Dulcolax: 

• Age 3-5y: Take 1 Dulcolax at noon only. 
• Age 6-11: Take 1 Dulcolax at 12 noon and 3 pm. 
• 12y +: Take 2 Dulcolax at 12noon and 3pm
• Babies under 1 year old: Clear fluids for 24 hours. Please wake your baby 6 hours before the procedure to give a bottle of clear fluid drink. This will keep your baby hydrated. Only breast milk may be given up to 4h before the time you are told to be at the surgery center. CLEAR FLUIDS: Water, Apple Juice, Pedialyte, ​Gatorade. (not red)

Magnesium Citrate 

Use 10-ounce bottles of chilled Magnesium Citrate. Either cherry or lemon-lime flavored is acceptable. (Children usually prefer the cherry flavor.) This is acceptable even though it is red. The child should drink the dose of Magnesium Citrate within 20 minutes.  

• ​Age 18 Months – 4 Years: 2:00 pm the day before the procedure, give your child ¼ bottle  7:00 pm, give another ¼ bottle. The child’s stools should be watery and clear by 10:00 p.m.
• 4 Years – 8 Years: At 2:00 pm the day before the procedure, give the child ½ bottle.7:00 pm, give another ¼ bottle. The child’s stools should be watery and clear by 10:00 p.m.
• 8 Years – 18 Years: At 2:00 pm the day before the procedure, give the child one bottle.At 7:00 pm, give another bottle. The child’s stools should be watery and clear by 10:00 p.m.

Lactose/Fructose/Sucrose/Glucose Breath Test

Hydrogen breath test protocols using Breathe EZ Systems Inc.

The night before the test please avoid foods high in starch. See the following list for these foods.

The day before-do not eat slow-to-digest foods such as beans, bran, or high-fiber foods. You must fast after midnight with no food or water. You can brush your teeth but spit out the toothpaste and rinse with water. You must not smoke, sleep, or exercise vigorously for at least half an hour before the test. Please be sure that you have not taken any antibiotics for at least 10 days prior to the test.

Sucrose Breath Test

Prepare the solution you are going to drink - 3 tablespoons of sugar in 8 ounces of water

after midnight, drink the sugar 3 hours before the sucrose test. On arrival in my office, 1-2 breath samples are taken.

Lactose Breath Test

Drink 12 ounce glass of whole milk (cannot be flavored), 3 hours before arriving in my office for the breath test.  On arrival, we will take 1-2 breath samples and then you can leave.

Fructose Breath Test

Drink 2 glasses of apple juice, 3 hours before arriving in my office for the breath test.  On arrival, we will take 1-2 breath samples and then you can leave.

Glucose Breath Test (for SIBO)

In my office, you will receive glucose to drink.  You will remain in my office for at least 2 hours.  We will collect breath hydrogen every 20 minutes.  Sometimes we may have to extend the study until 3 hours depending on the patient.

An upper endoscopy can be done safely in very young children, and it is done at a surgical center, where the child will be asleep throughout the entire procedure.  The endoscope is very thin, flexible and allows the physician to examine the esophagus, stomach and duodenum.  Through this, biopsies can be obtained to provide more information that might allow an accurate diagnosis to be made of your child's condition.  Complications are rare, and most children tolerated this without any problem.  They will then go home on the same day.

A colonoscopy is different and that the colon is examined, using a colonoscope which is a little bit longer, and allows the colon to be examined usually up to the terminal ileum.  Through the channel of the colonoscope biopsies can be obtained to allow an accurate diagnosis to be made of your child's condition.  Sometimes polyps were removed using the colonoscope.  To have a colonoscopy however your child will need to undergo a colonoscopy prep the day before so that the colon can be carefully examined without any fecal material obstructing the view.  This is very important.  Again your child be completely asleep throughout the entire procedure and on waking, usually will be able to eat and drink normally.  After every anesthetic procedure, your child should be in a supervised situation for a day, older children should not be allowed to participate in sports, no driving is allowed.

Infusion Services

We do infusions in the office. Recently, many insurance companies have decided that infusions should be done outside the hospital setting. If you have a medication that requires an infusion and you do not have a place for infusion, please contact the office. We may be able to help.

We can provide infusions for:

• Remicade, Avsola
• Simponi Aria
• Entyvio