Bowel-prep cheat sheet · Pediatric Gastroenterology
Internal staff reference · Not for patient distribution

BIG PREP dosing per weight band

Band Dulcolax (bed+day) Tot. mg MiraLAX caps Tot. g Gatorade Cup Start
15-20 kg (33-44 lb)0 + 15 mg580 g20 oz3 oz1:00 PM
21-30 kg (46-66 lb)1 + 110 mg7120 g28 oz5 oz3:00 PM
31-40 kg (68-88 lb)1 + 110 mg10170 g40 oz7 oz3:00 PM
41-50 kg (90-110 lb)2 + 115 mg12200 g48 oz8 oz3:00 PM
Over 50 kg (>110 lb)2 + 220 mg14238 g64 oz8 oz3:00 PM

Infants <15 kg — two options (clinician choice)

Sub-band MiraLAX caps Tot. g Mix in (Pedialyte or clear apple juice)
<5 kg¼4 g2–4 oz
5–9 kg½8.5 g4–6 oz
10–15 kg¾13 g6–8 oz
Saline enema10 mL/kg — evening at home if directed, otherwise by staff at facility

MiraLAX schedule: 1 dose/day × 2 days (days −3 and −2). Patient handouts: u15kgPEG / u15kgEnema.

Contingency rescue plan if stools not clear/pale yellow after 4 h

Band Evening rescue Morning rescue
finish ≥ NPO before procedure
Hard stop
incl. BIG PREP
If still not clear
15-20 kg (33-44 lb)2 cap / 8 oz1 cap / 4 oz8 caps (136 g)NS enema (10 mL/kg) or reschedule
21-30 kg (46-66 lb)3 cap / 12 oz1 cap / 5 oz11 caps (187 g)NS enema (10 mL/kg) or reschedule
31-40 kg (68-88 lb)3 cap / 12 oz2 cap / 8 oz15 caps (255 g)NS enema or reschedule
41-50 kg (90-110 lb)4 cap / 16 oz2 cap / 8 oz18 caps (306 g)Enema or reschedule
Over 50 kg (>110 lb)4 cap / 16 oz2 cap / 8 oz20 caps (340 g)Enema or reschedule

Trigger: 4 h after starting BIG PREP without clear/pale-yellow watery stool. NPO clears: 2 h SCC / 3 h PMCH — morning rescue must finish ≥ that window before procedure time. If still not clear after rescue: call office (317) 338-9450. Infants <15 kg: not applicable — see <15 kg block.

Pre-cleanout (suspected constipation) option A + daily maintenance

Band Option A (intensive) Start Daily maintenance
15-20 kg (33-44 lb)1 cap / 4 oz clear × 1×/day × 5 d-5 d½ capful of MiraLAX daily
21-30 kg (46-66 lb)1 cap / 4 oz clear × 2×/day × 5 d-5 d½ capful of MiraLAX daily
31-40 kg (68-88 lb)1 cap / 4 oz clear × 4×/day × 3 d (weekend)weekend1 capful of MiraLAX daily
41-50 kg (90-110 lb)8 caps in 32 oz Gatorade over ~4 h (weekend)weekend1 capful of MiraLAX daily
Over 50 kg (>110 lb)10 caps in 40 oz Gatorade over ~4 h (weekend)weekend1 capful of MiraLAX daily

Locations

Surgery Center of Carmel (SCC)St. Vincent — PMCH Peds Preop
Address12188-A N Meridian St #150, Carmel, IN 460322001 W 86th St, Indianapolis, IN 46260 (Surgery Parking Lot)
Facility phone(317) 569-8250(317) 338-5851
NPO clears2 h before procedure3 h before procedure
Arrival60 min before90 min before
Mobile sitesprep.giready.com
egdcolon.giready.com
prep86.giready.com
egdcolon86.giready.com

When to call — post-procedure red flags office (317) 338-9450

  • Fever >101°F (38.3°C)
  • Stool that is black or has more than a small streak of blood
  • Severe or worsening abdominal pain, or hard / swollen belly
  • Persistent vomiting, or refusal to drink
  • Difficulty breathing or chest pain — emergency, call 911

Small blood with the first stool can be normal (especially if biopsies taken). Adult must stay 24 h after anesthesia. Most kids back to normal next day.

Medications to hold (7 days before)

  • Iron supplements — all bands
  • Anti-diarrhea medicine — all bands
  • GLP-1 agonists (Ozempic, Wegovy, Mounjaro) — 41-50 kg (90-110 lb), Over 50 kg (>110 lb) only

Unusual or unlisted meds: ask the family to prepare a list and call the office.