Bowel cleansing solutions (also called bowel preparation) is used to clear the bowel before a procedure at Great Ormond Street Hospital (GOSH). This allows the doctor to see the bowel wall during colonoscopy and similar procedures. The solutions used are senna, Picolax® or CitraFleet®.
The day before the procedure
Important – If your child is unwell or has been unwell recently, please contact us before giving the bowel cleansing medicine.
Your child should:
- 8am – have breakfast as normal.
- 10am – start the liquid diet, as shown on the chart in our bowel cleansing at home information sheet. Do not eat any solid foods from now until the procedure.
- 11am – mix each sachet of Picolax® or CitraFleet® with half a glass (125ml) of cold water. If the solution warms up, leave it to cool down before giving it to your child. Take a dose of senna followed by the dose of Picolax® or CitraFleet® as prescribed. Drink plenty of clear fluids for the rest of the day.
- 6pm – make up a fresh solution of Picolax® or CitraFleet®. Take the second dose of Picolax® or CitraFleet®.
The day of the procedure
If your child is on the morning list:
- do not drink any water or fluid from 6.30am
If your child is on the afternoon list:
- do not drink any water or fluid from 11.30am
It is important to keep giving your child food and drink until those times to ensure they remain well hydrated. This may involve waking your child in the night to give them a drink.
Side effects of bowel cleansing medicine
Your child may need the toilet urgently so it is advisable not to go too far from home after taking the bowel cleansing medicine. In addition, your child may have:
- stomach pain or cramps
Please take your child to your nearest accident and emergency (A&E) department if they are:
- Dehydrated from severe diarrhoea.
- Lethargic and listless.
- Have a rash, itchiness, redness and swelling – this may be an allergic reaction to the medicine.
Interactions with other medicines
If your child is taking any regular medicines on prescription, medicines bought from a pharmacy or any herbal or complementary medicine – check with your doctor or pharmacist before giving it to your child.
- Anti-clotting medicine such as aspirin or warfarin may need to be stopped before the procedure.
- Medicines by mouth – do not give these within an hour of giving bowel cleansing medicine.
Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.
For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.
For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.