Procedures

When your child has a procedure, it is important for you to understand that procedure so you can know how to prepare for it, and how to answer any questions or calm any fears you child might have. 

Make sure you know when and where your child's procedure will take place. Click here for a list of locations where these procedures are performed.

Before some procedures, you might need to have lab work completed. Click here for a list of lab locations in the Charlotte area.

Select the name of your child's procedure below to learn more. You will find a brief explanation of the procedure, and important instructions to follow to prepare your child.  

If you have any questions about preparing for any of these procedures, please call our office at 704-316-5060.


Upper Endoscopy/EGD

An endoscopy, also known as an upperendoscopy or EGD, is a test that allows your child's doctor to see into the linings of the esophagus (the swallowing tube), stomach and duodenum (the first part of the small intestine). After your child receives medicine to help him/her sleep, the doctor will insert a small, flexible, lighted tube with a camera on the end through your child's mouth. The doctor might also take tiny tissue samples, called biopsies. Endoscopies are often used to find out while a child is vomiting, having trouble swallowing or growing, or having belly pain.

The procedure takes 15 to 30 minutes. Please allow yourself three hours at the hospital. Your child can return to normal activities the day after the endoscopy.

Instructions

To keep your child safe, his or her stomach needs to be COMPLETELY EMPTY at the time of the procedure.
  • IF YOUR CHILD IS AN INFANT, he or she may have infant formula/non-human milk up to 8 hours before the procedure, breast milk up to 6 hours before the procedure, and clear liquids up to 4 hours before the procedure.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE MORNING, he or she should have nothing to eat or drink after midnight. This includes water.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE AFTERNOON, he or she should not have solid foods after midnight the day before. You will be given a specific time to begin complete fasting. Until the time given, your child can have: water, tea, sodas; clear fruit juices without pulp (apple juice, lemonade, white grape juice); Pedialyte; yellow green or clear Gatorade/Powerade (NO red, orange, purple or blue flavors); yellow or green Jell-O and popsicles, including banana flavors; and chicken or beef broth/boullion.
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Colonoscopy

A colonoscopy lets your child's doctor view the entire large intestine (colon). This test is often done to find the cause of belly pain, diarrhea or blood in poop.

After your child receives medicine to help him or her sleep, the doctor will insert a long, flexible tube with a camera and light on the end in through your child's bottom up to the colon. This lets the doctor see abnormalities, and possibly even treat minor problems. The doctor might also take tiny tissue samples called biopsies.

Instructions

Your child's large intestine must be COMPLETELY EMPTY of poop for the colonoscopy to be accurate and safe. We will instruct you on the best colon preparation method for your child. YOUR CHILD WILL ALSO NEED TO DRINK PLENTY OF CLEAR LIQUIDS, AND NOT EAT ANY FOOD LEADING UP TO THE PROCEDURE.

Your child will be on a clear liquid diet the day before the procedure. Clear liquids include:water, tea, sodas; clear fruit juices without pulp (apple juice, lemonade, white grape juice); Pedialyte; yellow green or clear Gatorade/Powerade (NO red, orange, purple or blue flavors); yellow or green Jell-O and popsicles, including banana flavors; and chicken or beef broth/boullion.

Any of those clear liquids should also be used to mix with the Miralax. Your child should start taking the Miralax between 9:00 a.m. and 10:00 a.m. the day before the procedure. You may wait until after school to start the prep, but your child must take one dose every half hour instead of every hour.

  • IF YOUR CHILD IS 1-3 YEARS OLD, mix 2 rounded teaspoons will 4 ounces of clear liquid ever hour until your child's poop is clear and watery.
  • IF YOUR CHILD IS 4-12 YEARS OLD, mix 3 rounded teaspoons with 4 ounces of clear liquid ever hour until your child's poop is clear and watery.
  • IF YOUR CHILD IS 12 YEARS OLD OR OLDER, mix 1 capful (17 grams) with 8 ounces of clear liquid every hour until your child's poop is clear and watery.
NOTE: IF YOUR CHILD'S POOP IS NOT CLEAR AND WATERY BY 6:00 P.M. START GIVING THE ABOVE AMOUNT EVERY 30 MINUTES UNTIL YOUR CHILD'S POOP IS CLEAR AND WATERY.
The procedure itself will take 30-45 minutes. Please allow yourself 3 hours at the hospital. Your child may return to normal activities the day after the colonoscopy.

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Capsule Endoscopy

A capsule endoscopy lets your child's doctor examine the small intestine (the digestive tube that leads out of the stomach). Capsule endoscopies are used to identify the cause of bleeding, and to detect abnormalities of the small intestine.

The doctor places a sensor device onto your child's abdomen, and your child swallows a pillcam (a very tiny camera). As the camera passes through your child's digestive tract, it takes pictures for the doctor to examine. The pictures are transmitted to sensors placed on your child's abdomen. These sensors are connected to a small data recorder your child will wear around his or her waist. The capsule is disposable, and is normally eliminated as your child goes to the bathroom within 24 hours.

Instructions

PLEASE READ AND FOLLOW ALL OF THESE INSTRUCTIONS. IF YOU DO NOT FOLLOW THESE INSTRUCTIONS, YOUR CHILD'S PROCEDURE WILL BE CANCELLED AND WILL NEED TO BE RESCHEDULED.
  • Do not allow your child to eat anything after 12:00 p.m. the day BEFORE the test, until you receive further instructions from the hospital.
  • After 10:00 p.m the evening before the test, DO NOT ALLOW YOUR CHILD TO EAT OR DRINK ANYTHING!
  • Please arrive and check in at the Admitting department in the front lobby of the hospital.
  • Your child should wear loose, 2-piece clothing (shirt and shorts/pants) for the test.
  • Contact the doctor immediately if your child has any abdominal pain, nausea or vomiting after ingesting the capsule.
  • You will be asked to record your child's activities (eating, drinking, unusual sensations) during the test.
  • Every 15 minutes during the test, make sure the small light on the top of the recorder is blinking. If for some reason it stops, please record the time and contact the hospital as soon as possible.
  • The capsule endoscopy will last 8 hours. The equipment is very expensive, and any damage to it will be the financial responsibility of the parents/guardians. Please make sure your child avoids strenuous activity.
  • The hospital will instruct you on the time to return to the hospital to return equipment and have the sensors removed.
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pH Probe

Your child's doctor might do a pH probe to find out if acid from the stomach is coming up through the esophagus (food tube). The doctor will put a thin, flexible tube through the nose, down the back of the throat, and into the esophagus. The tube is taped in place, and the end of the tube is attached to a small recording machine, which can be buckled to your child's waist or carried over a shoulder.

Before the test, the nurse will check your child's height to determine where to place the tube, and then pass the tube through your child's nose. You may stay with your child while this happens. Passing the tube may cause your child to cough, sneeze or gag. The feeling will pass once the tube is taped in place, and then the tube should not bother your child.

Once the tube is taped in place, your child will have an x-ray to check the position of the tube. Special sleeves may be put on infants and small children to prevent them from pulling out the tube.

The tube wil stay in place for 18 to 24 hours while the machine records data. You will keep a diary of your child's activities during this time.A member of the GI staff will remove the tube the next day. Removing the tube takes less than a minute, and does not hurt.

Instructions

Your child must have an empty stomach for a pH probe. YOUR CHILD SHOULD HAVE NOTHING TO EAT OR DRINK FOR 4 HOURS BEFORE THE PROCEDURE, EXCEPT FOR WATER, APPLE JUICE OR BREAST MILK (which is allowed up to 2 hours before the procedure).

Sometimes before this test we will need your child to stop taking medicines that reduce acid. Your child's doctor will let you know if this is necessary, but if you are uncertain, PLEASE ASK!

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Bravo pH Monitoring

The Bravo pH Monitoring System lets your child's doctor monitor how much acid is in your child's esophagus (swallowing tube) to find the cause of heartburn or acid reflux (GERD). The doctor will use a small instrument to insert the Bravo capsule (about the size of a gel cap pill) through your child's mouth or nose into the esophagus. The capsule clings to the wall of the esophagus using suction. For 48 hours, measurements from the capsule are transmitted to a small receiver that can be worn on your child's waistband.

Your child can eat normally and engage in normal activities during the test.During the test, you will be asked to monitor your child's symptoms, and note their activities, and food and drink consumption. Let your child eat and drink normally, but DO NOT LET THEM CHEW GUM OR SUCK ON HARD CANDY.
Make sure the receiver does not get wet. It is not waterproof! You will return the receiver and your notes when the monitoring period is over.The disposable capsule will detach through normal activities in 7 to 10 days, and will come out through the digestive process.

Instructions

Your child needs to have an empty stomach and a system free of certain medicines before the capsule is placed.

  • One week before the test, your child must stop taking: omeprazole (Prilosec); lansoprazole (Prevacid); rabeprazole (Aciphex); pantoprazole (Protonix); and esomeprazole (Nexium).
  • Two days before the test, your child must stop taking: ranitinide (Zantac); cimetidine (Tagamet); famotidine (Pepcid); nizatidine (Axid); and metoclopramide (Reglan).
Your child can resume normal diet and medications after the monitoring period is over. The capsule contains a magnetic element, so your child should not have any MRI exams for 30 days after the capsule is placed.

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PEG Tube Placement

If your child is unable to get adequate nutrition through regular feeding, your doctor might recommend a feeding tube. A PEG (percutaneous endoscopic gastronomy) Tube is one type of feeding tube. After your child receives medicine to help him/her sleep, the doctor will insert a small, flexible, lighted tube through your child's mouth, down the esophagus (swallowing tube) and into the stomach. The light on the end of the tube helps the doctor see the where the tube is inside your child's stomach. The doctor will make a small incision to pull the tube out so it can be accessed to feed your child. This insertion normally takes about 20 minutes.

Instructions

To keep your child safe, his or her stomach needs to be COMPLETELY EMPTY at the time of the procedure.

  • IF YOUR CHILD IS AN INFANT, he or she may have infant formula/non-human milk up to 8 hours before the procedure, breast milk up to 6 hours before the procedure, and clear liquids up to 4 hours before the procedure.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE MORNING, he or she should have nothing to eat or drink after midnight. This includes water.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE AFTERNOON, he or she should not have solid foods after midnight the day before. You will be given a specific time to begin complete fasting. Until the time given, your child can have: water, tea, sodas; clear fruit juices without pulp (apple juice, lemonade, white grape juice); Pedialyte; yellow green or clear Gatorade/Powerade (NO red, orange, purple or blue flavors); yellow or green Jell-O and popsicles, including banana flavors; and chicken or beef broth/boullion.
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Manual Disimpaction

If your child is unable or unwilling to use the toilet to get rid of waste, that waste can accumulate and become dangerous to your child's health. In some cases, your doctor might recommend a manual disimpaction to remove the waste and relieve your child's discomfort. After your child is given medicine to help them sleep, your child's doctor will remove the excess waste through the rectum.

While your child is asleep, the doctor might place an NG tube (a soft tube which runs through the nose into the stomach). Your child would then be admitted for an NG Golytely flush to completely cleanse the digestive system.

Instructions

To keep your child safe, his or her stomach needs to be COMPLETELY EMPTY at the time of the procedure.
  • IF YOUR CHILD IS AN INFANT, he or she may have infant formula/non-human milk up to 8 hours before the procedure, breast milk up to 6 hours before the procedure, and clear liquids up to 4 hours before the procedure.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE MORNING, he or she should have nothing to eat or drink after midnight. This includes water.
  • IF YOUR CHILD IS NOT AN INFANT AND HAS A PROCEDURE IN THE AFTERNOON, he or she should not have solid foods after midnight the day before. You will be given a specific time to begin complete fasting. Until the time given, your child can have: water, tea, sodas; clear fruit juices without pulp (apple juice, lemonade, white grape juice); Pedialyte; yellow green or clear Gatorade/Powerade (NO red, orange, purple or blue flavors); yellow or green Jell-O and popsicles, including banana flavors; and chicken or beef broth/boullion.
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