Practical advice before procedure

Bowel Prep
This is the term used to encompass the technique to clean the large bowel of faeces prior to doing a colonoscopy. It will require that your child comes into hospital with you in the late afternoon prior to the colonoscopy and at that junction the nurses will give two types of medicines which work as strong laxatives to clear the bowel. This will usually be given at 6pm and then again early in the morning prior to the procedure. This will result in diarrhoea which unfortunately is necessary to clear the bowel out properly. If your child’s bowel motions are not clear approximately 1 hour before the procedure then an enema will be administered in order to clear the rectum out effectively.

What happens during admission

You will come in either the night before the procedure for colonoscopy and more complicated endoscopic procedures or on the morning of the procedure and you will have had an opportunity to talk to Kate King, Practice Manager, and Dr Thomson prior to coming in to the hospital regarding what this will involve. In essence no solid food will be given if you come in the night before for bowel preparation for colonoscopy and no foods or milk should be given after 2.30am on the morning of the procedure before an endoscopy. For an endoscopy you will be expected to be in the hospital by no later than 7.30am and clear fluids may be given up until 6.30am.

When you come to the hospital you will be directed to the appropriate floor where the nursing staff will be expecting you and will go through a nursing clerking procedure. You may see one of the junior doctors who come in the night before who will do a medial clerking procedure which is just a formality to ensure that your child is well. you will see Dr Thomson who will go through any questions you might have that are remaining, and this might be on the ward or in the theatre complex prior to the procedure. The consent document is usually signed and organised in the outpatient setting prior to admission but may occasionally occur during the hospital admission prior to the procedure.

By this time your child will have been changed into a theatre gown and you will also have seen the Anaesthetist, usually Dr Lloyd-Thomas (www.AL-T.dial.pipex.com) who is a very experienced Paediatric Anaesthetist and one of the best in the country at his job and your child will therefore be in extraordinarily safe hands. He will explain the whole anaesthetic procedure and details of this and the pre-anaesthetic arrangements are available on his web page. You and your child will go down to the endoscopy theatre and you will be able to stay with him/her until they go to sleep and then you will be escorted back to the ward. When the procedure is finished which usually takes 10 minutes (maximum 20 minutes) for the colonoscopy you will be invited to come down the recovery area which your child will be waiting. The whole time you are away from your child may take longer because of the waking up time in the recovery area and there will be a recovery nurse there to explain what has happened. At this time Dr Thomson will come through and explain the findings if there are any which were seen by the naked eye, give you a video of the procedure, and with the aid of a diagram and photographs show you what was found, if anything. It is important to remember that the biopsies that are taken may actually be able to provide a lot more information when they are looked at under the microscope than the naked eye appearances at endoscopy. You will have the opportunity at this point again to ask any questions that arise.

If any immediate medical treatment is needed this will be prescribed and you will return to your room with your child for a period of time until the nursing staff and yourselves are happy that your child has drunk and eaten and is able to go home. If a pH probe is placed at the time of endoscopy it may be that you elect to stay in the hospital overnight with your child and then the probe would be removed simply by gentle withdrawal the next morning. Dr Thomson will be available to the nursing staff during the time your child is an inpatient should any problems occur or questions arise that you may have. Blood tests are usually taken whilst your child is asleep rather than when they are awake in order to minimise any discomfort or bad experiences.

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