Pediatric Colonoscopy (Lower Endoscopy)

Our experienced pediatric team specializes in a minimally invasive procedure called a colonoscopy. This procedure works to diagnose and treat many digestive disorders in children. Doctors across North Texas send their patients to us because we can take care of children with the most challenging digestive disorders. We use the latest, most advanced technology and tools to carefully examine your child’s digestive tract and can often provide treatment during the same procedure.

What are colonoscopy and flexible sigmoidoscopy?

A colonoscopy is a test that allows doctors to look inside the large intestine (also called the colon) and the last section of the small intestine. Also called lower endoscopy, this test uses an endoscope (narrow, flexible tube with a light and tiny camera) to see and take photos inside the intestines.

A flexible sigmoidoscopy is like a colonoscopy, but it examines a shorter section of the large intestine. A sigmoidoscopy requires less preparation than a colonoscopy.

These tests provide information about your child’s large intestine that other imaging and tests cannot show. Sometimes, we take small tissue samples (biopsy) and remove growths called polyps (polypectomy) during the same procedure.

What are the differences between colonoscopy and flexible sigmoidoscopy?

A colonoscopy and a flexible sigmoidoscopy are similar, however, the two procedures have certain differences:

What are the benefits of colonoscopy and flexible sigmoidoscopy?

For your child, the benefits of having a colonoscopy or a flexible sigmoidoscopy at Children's Health℠ include:

• Dedicated team of specialized GI nurses: Our nurses have specific training and work only in pediatric endoscopy procedures for GI conditions. That means your child receives care from nurses who focus on caring for children having a colonoscopy, sigmoidoscopy or other endoscopic procedure.

• Pediatric-trained doctors: In many hospitals, children receive care from doctors who also work with adults. Our gastroenterologists and anesthesiologists have specialized training in pediatric health care and work exclusively with children. They’re experienced in procedures, techniques, instruments, medications and other care that’s tailored specifically for children.

• Easier recovery for your child: Recovery time after a colonoscopy or a flexible sigmoidoscopy is quick because the procedure involves no incisions (cuts). If our doctors are able to treat the condition during the same procedure, your child can quickly get back to their active lifestyle.

A child might need a colonoscopy or a flexible sigmoidoscopy for GI symptoms such as:

• Abdominal (belly) pain

• Chronic (long-term) diarrhea or constipation

• GI bleeding

• Nausea and vomiting

Treatments that our doctors may perform during the same colonoscopy or sigmoidoscopy procedure include:

• Decompression of obstructed colon

• Foreign body removal

• Removal of colon polyps (polypectomy)

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What are the side effects of colonoscopy and flexible sigmoidoscopy?

A colonoscopy or a flexible sigmoidoscopy can cause side effects for some children. These may include:

• Bloating and pain caused by gas

• Cramping or discomfort caused by the scope

• Dizziness

• Fatigue (tiredness)

• Upset stomach or vomiting

At Children’s Health, our care team does everything possible to help your child have a comfortable experience. Our nurses monitor your child closely and ensure they’re comfortable as they wake up from the anesthesia (after a colonoscopy). We check their blood pressure, pulse and breathing and may give them clear liquids such as clear juice before discharge.

What are the risks of colonoscopy and flexible sigmoidoscopy?

A pediatric colonoscopy is safe and effective, but it has risks, like any invasive procedure. Your child’s doctor will discuss any possible complications, such as:

• Reaction to the anesthesia or pain medication

• Nausea, vomiting, bloating or irritation caused by the bowel cleanse prep and/or the colonoscopy

• Bleeding, if your child had a biopsy or polyps removed

• Peritonitis (inflammation of the lining of the abdominal cavity) (very rare)

• Perforation (hole) in the intestinal wall (very rare)

At Children’s Health, your child’s care team works to minimize the risk of complications with a colonoscopy. Your child’s health and safety are our utmost priorities.

What are Children’s Health’s outcome metrics for colonoscopy and flexible sigmoidoscopy?

Your child receives care from doctors with extensive experience in pediatric endoscopy procedures, including the most advanced techniques, for even the smallest babies. Our pediatric gastroenterologists and their teams are dedicated to providing the safest possible experience for your child. Each year, our team performs nearly 3,000 general and advanced endoscopy procedures for children.

What to expect with colonoscopy and flexible sigmoidoscopy

At Children’s Health, our pediatric gastroenterologists perform colonoscopies and sigmoidoscopies in our state-of-the-art gastroenterology (GI) lab. These tests are outpatient procedures, so your child will be able to go home the same day.

The procedure takes about 1 hour, and it will take about another hour for your child to wake up from the anesthesia. A pediatric colonoscopy is an outpatient procedure, so your child will be able to go home the same day after the test.

What to expect before colonoscopy and flexible sigmoidoscopy

Once we have scheduled your child’s colonoscopy or sigmoidoscopy, the care team will explain the procedure in detail and answer your questions. We will ask you about your child’s medications and any allergies to medication.

We provide you with detailed instructions about how to prepare your child for the procedure and how to care for them afterward:

• For a colonoscopy, you’ll receive instructions for the bowel preparation and special diet.

• For a sigmoidoscopy, your child probably won’t need to do bowel prep, but they may need to stop eating at a certain time the night before.

If your child has a heart valve disease, they may receive antibiotics before the procedure. Depending on your child’s specific health needs, the doctor may request other specific preparation.

What to expect during colonoscopy and flexible sigmoidoscopy

You’ll need to arrive a bit before the procedure so that we can prepare your child:

• For a colonoscopy, our pediatric anesthesiologist will give your child medicine to help them sleep through the procedure and feel no pain.

• For a sigmoidoscopy, we’ll give your child an enema to clean out their colon. Your child may or may not have sedation medication or general anesthesia.

You can be with your child during preparation, and then you can go to the waiting room during the procedure.

During the procedure, the gastroenterologist will insert an endoscope through your child’s anus (end of the intestines where stool exits the body). The doctor carefully guides the scope through the colon to look for swelling, growths and other problems:

• For a colonoscopy, we’ll use the scope to examine the entire colon and last section of the small intestine.

• For a sigmoidoscopy, the scope goes a shorter distance, through the rectum and the sigmoid colon.

If the doctor sees any suspicious areas, they will take pictures and may also take tiny samples of tissue to examine later in the laboratory. They may also remove colon polyps during this same procedure.

What to expect after colonoscopy and flexible sigmoidoscopy

After the procedure, a nurse will take your child to the post-anesthesia care unit (PACU, also called the wake-up room ). If your child receives sedation or anesthesia, our nurses will monitor them as they wake up.

Your child's doctor will discuss with you how the procedure went and may show you images taken during the test. You can then join your child and take them home after about one hour.

To help avoid nausea and vomiting after the procedure, your child should avoid spicy or greasy foods as their first meal. Our care team can recommend some foods and will provide complete instructions on how to care for your child at home.

If we do a biopsy, it will take about one week for the results to come back. We will call you with the results.

How do I prepare my child for colonoscopy?

These bowel prep instructions will help you get your child ready for a colonoscopy. The goal of this one-day bowel cleansing is to get your child’s stool to become a clear liquid with no pieces of stool. By carefully following these instructions, your child’s colon will be empty so the doctor can see all the tissue inside that would otherwise be hidden by stool.

It’s important to note that if your child’s colon isn’t completely empty, we will have to cancel the colonoscopy and reschedule it for another day. That means that your child will have to go through the bowel prep process again.

Download the instructions in English (pdf) or Spanish (pdf).

What are the Child Life services for colonoscopy and flexible sigmoidoscopy?

Child Life specialists are available to meet with your child before the procedure to help put them at ease and know what to expect.

What questions should I ask my provider about colonoscopy and flexible sigmoidoscopy?

Some questions you may want to ask your child’s care team include:

• Will my child need to spend the night at the hospital after a colonoscopy or sigmoidoscopy?

• Are there other test or treatment options for my child?

• What medications should my child stop taking before a colonoscopy or sigmoidoscopy?

• Will my child go home with any special equipment after a colonoscopy or sigmoidoscopy?

• How soon will I be able to see my child after a colonoscopy or sigmoidoscopy?