EGD, Colonoscopy + Capsule Prep
🔎 What Are These Procedures?
Your child is scheduled for three things in one visit, all while asleep under anesthesia:
- EGD (upper endoscopy) — a thin camera is passed through the mouth to look at the esophagus, stomach, and the first part of the small intestine. Small biopsies are usually taken.
- Colonoscopy — the same kind of camera is passed through the bottom to look at the large intestine. Biopsies are usually taken here too.
- Capsule camera — a camera about the size of a large vitamin is placed into the small intestine through the same scope. Your child does not have to swallow it.
Why a capsule? The small intestine is the long middle stretch between the stomach and the colon. In a teenager or an adult it is about 15 feet long, and neither the EGD nor the colonoscopy can reach most of it.
How it works. The capsule travels the whole way on its own, taking thousands of pictures as it goes, and comes out on its own in a bowel movement. This is the one way we can see that entire stretch in detail.
The EGD and colonoscopy together take about 30–60 minutes, and your child will not feel any of it. The capsule keeps taking pictures after you go home and stores them inside itself.
📖 About the Bowel Prep
The colon must be clean for the doctor to see clearly during the colonoscopy. The medicines below clean the colon (empty it) over the day before. The EGD itself does not need bowel prep — only the fasting times.
The same prep serves the capsule — finishing the medicines matters for the capsule pictures as much as for the colonoscopy.
Prepare a list of medications.
Stop iron, anti-diarrhea medicine 7 days before.
You can verify what medications need to be stopped at meds.giready.com.
⚠️ If any history or suspicion of constipation, please do a pre-cleanout before the regular prep timeline below:
1 capful in 4 oz of clear liquid, 4 times daily for 3 days — best done over the weekend before the procedure
Then continue prescribed daily laxatives, or at least 1 capful of MiraLAX daily, until the procedure.
✅ Medications and Supplies needed
Pick up any prescription as soon as possible after scheduling. Buy all other supplies at least 5 days before the procedure. Check the active ingredient on the label.
| Active ingredient / Item | What to get |
|---|---|
| Bisacodyl 5 mg tablets (Dulcolax Tablets — Overnight Laxative) ⚠️ NOT Dulcolax liquid or soft-chews |
2 Dulcolax 5 mg tablets (10 mg total) |
| Polyethylene glycol 3350 (MiraLAX, LaxaClear, ClearLax, etc.) ⚠️ NOT MiraLAX chewables |
15 capfuls (255 g) enough for big prep with rescue — one 510 g bottle or two 238 g bottles |
| Gatorade or Powerade (any color except red or purple) — for mixing with the MiraLAX powder | At least 60 oz (~1750 mL) |
| Skin protection — protective ointment (Desitin or Vaseline) for anal-area comfort | 1 tube |
📅 2 Days Before the Procedure
If you forget the bedtime Dulcolax dose: on the day of prep, give 2 tablets (10 mg) with or just before the MiraLAX — that's the bedtime dose (1 tablet (5 mg)) added to the scheduled day-of dose (1 tablet (5 mg)). Don't skip — combine.
📅 1 Day Before — Diet & Bowel Prep
Two parts today: the diet below, then THE BIG PREP — the bowel-prep medicines — in the afternoon and evening.
The Diet — breakfast & lunch: Low-Residue (“White”) foods
Low-residue foods only — the table pairs meals that work with the ones to skip. Nothing with whole grains, red meat, nuts, seeds, popcorn or beans, and nothing fried or greasy. No vegetables that day except plain potato without the skin; fruit only if it is soft and peeled.
| ✅ OK to eat (breakfast & lunch) | ❌ Instead of |
|---|---|
| Scrambled eggs + white toast with butter | Whole-wheat toast, oatmeal with nuts or berries |
| Pancakes or waffles, plain or with syrup | Whole-grain waffles, berries, granola topping |
| Grilled chicken sandwich on white bread, no lettuce or tomato | Burger and fries, pizza, anything fried |
| Mac & cheese + applesauce | Salad, raw veggies, corn |
| White rice + baked chicken or fish + banana | Brown rice, beans, steak or ground beef |
| Snacks before 2 PM: plain yogurt, pudding, Jell-O, white crackers, pretzels, melon | Granola bars, popcorn, trail mix, fruit with the skin on |
After 2:00 PM — Clear Liquids Only
No more solid food. No dairy — no milk, yogurt, or ice cream.
| ✅ OK to drink | ❌ Skip that day |
|---|---|
| Water, apple juice, white grape juice | RED or PURPLE drinks or foods |
| Lemonade, clear soda, clear broth | Dairy (milk, yogurt, ice cream); juices with pulp |
| Popsicles, plain Jell-O, tea/coffee without milk | Any solid food |
🥤 THE BIG PREP — the bowel-prep medicines (afternoon / evening)
Best to start right after school — don't delay too long, or your child may not finish before bedtime.
Have your child drink 7 oz (~200 mL) every 30 minutes until finished.
Drink each cup fast (don't sip slowly — quick drinking helps the stomach empty and reduces nausea). If your child can't keep up, pause 30 minutes and resume. If your child vomits, wait 30 minutes and restart at a slower rate.
- Expect diarrhea — this is normal and means the prep is working. Stool will turn light-colored or yellow (tinted by the Gatorade) — that's the sign the colon is clearing.
- Keep giving clear liquids throughout the day.
- Between prep cups and after the last cup, offer a few small sips of clear liquids every 30–60 minutes through the prep day.
Anonymous · about 1 minute
Rescue plan — if stools are not clear or pale yellow 4 hours after starting (or if no stools), give extra MiraLAX:
- Evening: give 3 more capfuls of MiraLAX in 12 oz of Gatorade.
- Morning: give 2 more capfuls in 8 oz of Gatorade, at least 2 hours before procedure.
📅 Day of Procedure
- Clear liquids are allowed up until 2 hours before the procedure — nothing by mouth after that. No solid food the day of.
- Bring comfort items for your child (toy, blanket, tablet, etc.).
- All three happen during the same nap. The capsule goes in early, within a few minutes of your child falling asleep; the EGD (through the mouth) and the colonoscopy follow.
- Your child will likely be given a small amount of a liquid medicine right before the procedure. It improves the pictures the capsule camera takes.
- Tell your child what is happening afterwards — they are the one who will be using the toilet, and the capsule must not be flushed.
Keeping the stomach and small intestine empty while the capsule travels through gives the camera a clear view.
- First 2 hours after the capsule was placed
Nothing to eat or drink (NPO). - Between 2 and 4 hours after the capsule was placed
Only clear liquids. - At 4 hours after the capsule was placed
A light meal, and one more dose of MiraLAX — 1 capful of MiraLAX in 8 oz of a clear drink.
Pre-printed times above may be estimates. Always check with the team if unclear. The clock starts when the capsule actually goes in, or about at the start of the procedure.
📦 Finding the Capsule and Mailing It Back
We give you the collection kit after the capsule is placed — it comes in the box the capsule arrives in. Everything below is in it.
- Set up the silicone hat — “the most important piece in the kit”. It is a collapsible cup with a perforated bottom that sits under the toilet seat. Set it up before your child's first bowel movement after the procedure, and use it for every bowel movement until the capsule is found — including on days you think it has already passed.
- Keep a bottle or a cup of (warm) water next to the toilet. Always rinse the silicone hat after stooling and look carefully for the capsule.
- Use the magnetic wand (AKA “the magic wand”) to lift the capsule out without touching.
- Slide it off the wand using the lid of the box, then put the capsule back in the small plastic box it came in (you can seal the box with the barcode stickers from the kit).
- Mail it back as soon as possible. Sealed box goes into the pre-labeled FedEx envelope, dropped at any FedEx drop-off location, staffed or unstaffed. Nothing to pay, no trip to our office.
The kit also has a bag for the supplies, or for carrying the silicone hat with you if you are away from home. School is fine — your child can go to school with the capsule inside, and the hat folds up and fits in the bag if you want to send it along.
Not sure whether what you found is the capsule? Keep it and call us — we would much rather look at something that turns out to be nothing. Any problem at all, call us and we will sort it out.
📢 When to Call Us
Call us at (317) 338-9450. After hours, the same number reaches the provider on call.
These procedures are very safe and complications are extremely rare.
A sore throat, mild cramping and extra gas are common. Streaks of blood in the first stool or in vomit can be normal after biopsies.
- More than about a tablespoon of blood, in stool or in vomit
- Stool that is black
- A temperature over 101°F (38.3°C)
- A severe or persistent sore throat, drooling or trouble swallowing
Call the office, or go to the nearest emergency room if you are concerned.
No MRI scan and no strong magnets near your child's body until the capsule has passed.
Do not fly on an airplane until the capsule has passed.
Metal detectors, the microwave, phones and tablets, and weak magnets such as refrigerator magnets are all fine.
- Abdominal pain that keeps getting worse: often just a symptom, however it can signal a stuck capsule
- A swollen abdomen, or one that feels hard — especially if your child is not passing stool or gas
- Vomiting that does not stop, or vomiting green, yellow or dark material
- Trouble breathing, or chest pain
Results typically take about 2–3 weeks after the capsule reaches the download center. Reports are available as a PDF, a printed copy, and online through a portal.
Helpful Resources
After the procedure — recovery
- Your child will wake up in the recovery area. Some grogginess and gas/cramping/bloating are normal for several hours.
- A small amount of blood with the first stool after a colonoscopy can be normal, especially if biopsies were taken.
- An adult must stay with your child for 24 hours after anesthesia.
- No school, daycare, or sports for the rest of the day. Most children are back to normal activity the next day.
- The doctor will discuss what was seen before you go home. Biopsy results take about 1–2 weeks.