This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request.

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1 Information for parents This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request. This leaflet tells you about a colonoscopy What is a colonoscopy? A colonoscopy is an examination that allows your child s doctor to see inside their large intestine (bowel or colon). This is the best way of looking inside your child s bowel. For children this will be carried out under a general anaesthetic (a state of carefully controlled and supervised unconsciousness that means your child is unable to feel any pain). How long will the examination take? The examination will take approximately minutes. However, your child will be away from you for longer than this while they are waking up from the general anaesthetic. What are the risks and possible complications? Colonoscopy is a very accurate examination but occasionally a problem may be missed. It is a safe procedure but does have some risks and possible complications. The risks and possible complications include: bloating. Your child may feel bloated for a few hours afterwards. rectal bleeding. 1 patient in every 200 can suffer rectal bleeding. 1,2 perforation (hole). 1 patient in every 700 can suffer a perforation in the wall of the bowel. 1,2 Paed/483 Page 1 of 6 For Review Spring 2018

2 How can I help to prepare my child? It is very important that your child s bowel is empty and clean or certain areas of their bowel will be hidden and their colonoscopy may have to be rearranged. You will have received a letter advising you on how to give your child Picolax (bowel clear out medicine). You must follow these instructions. You must make sure your child is within easy reach of the toilet once they have taken the Picolax. Be prepared for them to have their bowels opened several times during the late afternoon and early evening. It will be like having diarrhoea (very loose watery bowel motions (poo)). Common effects of Picolax are: nausea (feeling sick) vomiting (being sick) bloating abdominal pain anal irritation (itchy opening to your back passage) wind disturbed sleep. If any of these symptoms become severe you should telephone the unit where your child is to have their examination or you should contact the GP Out of Hours Service (see contact numbers at the back of this leaflet). Before your child s examination you must: tie back long hair for comfort remove any nail varnish remove any make-up remove all jewellery. Please do not bring any valuables with your child. What will happen when we arrive for my child s appointment? An anaesthetist will discuss this with you and your child on the morning of their examination. You will have been given magic numbing cream which you should put on the back of your child s hands before coming to hospital. This will help to reduce the pain your child may experience when a cannula is inserted. Paed/483 Page 2 of 6 For Review Spring 2018

3 When you arrive at the Paediatric Day Unit (PDU), you and your child will be introduced to nursing staff and a play specialist who will be looking after your child for the day. A nurse will check your child s personal details, ask questions about their health, check their blood pressure and pulse and explain the examination and risks to you. This is just to make sure you understand everything before you sign the consent form. You should tell the nurse if your child has had any allergies or reactions to drugs or other tests in the past and of any previous colonoscopies. What will happen during my child s examination? If your child has a gas induction a clear mask will be placed over your child s face and your child will breathe in the anaesthetic. If your child has drug induction medication this will be given directly into your child s cannula (a fine tube inserted into a vein in the back of your child s hand or arm using a small fine needle). A colonoscope (a soft, flexible tube about the thickness of your finger) is passed into your child s rectum (bottom) and guided through their large intestine (see diagram below). This tube has a bright light and a camera at the end of it that passes back a picture of the inside of their bowel on to a monitor. Your child s endoscopist can then check to see if any abnormalities are present. Biopsies (small pieces of tissue) can be taken at the same time, if needed. Taking the biopsies will not hurt your child in anyway. We routinely take photographs or videos of your child s insides during this procedure. These are used to help in your child s investigations and treatment. The pictures taken during the examination will be kept as part of your child s healthcare record. Can I go to theatre with my child? You and your child will go to theatre with a play specialist from the PDU. Your child s name band and details will be checked by theatre nurses, then you will go to the anaesthetic room where the anaesthetic will be given. While your child is in theatre the play specialist will take you back to the PDU to wait until your child returns. What should my child wear? Your child should wear comfortable, loose fitting bottoms such as leggings or jogging bottoms not a onesie. Your child may go to theatre in their own clothes but sometimes a theatre gown may be needed. Paed/483 Page 3 of 6 For Review Spring 2018

4 What happens after the examination? Your child will be taken to the recovery area where they will be able to rest until the effects of the general anaesthetic has worn off. A nurse will collect them and take them back to the PDU. Your child will be offered a drink and something to eat when they are ready. Usually, if your child is not sick, their cannula is removed and you may take them home after about 1 hour. When will I be told the result of my child s examination? Before you leave the PDU your child s doctor will explain the results of their examination and any further plans. If your child had any biopsies taken and sent to a laboratory for further examination, you may have to wait for up to 6 weeks for the results. If needed, you may be sent an outpatient appointment through the post to discuss the results of your child s colonoscopy in more detail. A copy of your child s results will also be sent to their GP. How will my child feel when they get home? Your child may feel tired due to the effect of the anaesthetic. Do not worry, they should relax quietly at home for the rest of the day. Your child can eat, drink and take any medication as usual after their examination. As their bowel has been emptied it often takes 2 3 days for their bowel movements to return to normal. Your child may have some abdominal discomfort due to the air put into their bowel during the examination. This may make them feel like they need to pass wind. This usually settles within 24 hours. If any biopsies have been taken, your child may pass small traces of blood from their rectum for up to 48 hours after their colonoscopy. You must contact the Paediatric Day Unit (see contact numbers at the end of this leaflet) immediately if your child: has severe pain in their abdomen develops a temperature higher than 37.5 o C (99.5 o F) develops vomiting (being sick) or nausea (feeling sick) Paed/483 Page 4 of 6 For Review Spring 2018

5 has any bleeding from their rectum which increases or continues for more than 48 hours. If the department is closed and your child has an urgent problem the night after their procedure, you should contact your local Accident and Emergency Department. (see contact numbers towards the end of this leaflet). Contact numbers Paediatric Day Unit telephone: Monday Friday, 8.00am 9.00pm Children s Community Nurses telephone: Monday Friday, 9.00am 5.00pm Accident and Emergency Department telephone: hours a day, 7 days a week If you have any worries or concerns you should contact your GP during normal surgery hours. Outside surgery hours, you should contact your GP s surgery for the Out of Hours Service number. Further information is available from: NHS Choices telephone: 111 (when it is less urgent than 999) Calls to this number are free from landlines and mobile phones or via the website at References 1. Cotton P & Williams C. (2000) Practical Gastrointestinal Endoscopy 4 th edition Blackwell Science. 2. Fleischer D.E, Van-de-Mierop F, Eisen, G B, Benjami. S.B & Lewis J. H Et al. (1997) A new system for defining endoscopy complications emphasizing the measure of importance gastrointestinal endoscopy vol 45 pages Paed/483 Page 5 of 6 For Review Spring 2018

6 This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Quality Assurance Team, University Hospital of North Tees or Comments, Concerns, Compliments or Complaints We are continually trying to improve the services we provide. We want to know what we re doing well or if there s anything which we can improve, that s why the Patient Experience Team is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. If you would like to contact or request a copy of our PET leaflet, please contact: telephone: Monday Friday, 9.00 am 4.00 pm Messages can be left on the answering machine and will be picked up throughout the day. freephone: Mobile: (can use text): patientexperience@nth.nhs.uk Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person. telephone: hours a day, 7 days a week The Patient Experience Team is available to discuss your concerns in person Monday Friday, 1.30 pm 4.30 pm. Data Protection and use of patient information The Trust has developed a Data Protection Policy in accordance with the Data Protection Act 1988 and the Freedom of Information Act All of our staff respect this policy and confidentiality is adhered to at all times. If you require further information please contact the Head of Communications. telephone: or University Hospital of North Tees, Hardwick, Stockton-on-Tees. TS19 8PE University Hospital of Hartlepool, Holdforth Road, Hartlepool. TS24 9AH Telephone: Fax: Paed/483 Page 6 of 6 For Review Spring 2018