Learning About Bowel Clean Out for Your Child in a Healthcare Setting

A bowel clean out is a way to fully empty your child’s bowels of stool. It's done to relieve severe constipation. It might also be done before a test or surgery that involves your child’s bowels.

It’s common for children to be constipated. You can often treat constipation at home. But if treating it at home doesn’t work, or if your child is having certain other health problems, the doctor might recommend doing a bowel clean out.

There are two ways to do a bowel clean out in a healthcare setting. The first one involves drinking a large amount of a special liquid within a few hours (called oral clean out). The second one involves giving liquid through a tube in your child’s nose (called a nasogastric tube).

The doctor can try this approach if your child is old enough to understand and follow instructions.

To start an oral clean out, a nurse will prepare a special liquid for your child to drink. Often this will be a mix of a laxative (medicine to empty the bowels) and a balanced electrolyte or rehydration drink. The doctor or nurse will pick the drink and tell you how much to give each hour. Depending on your child's age and weight, your child will need to drink 4 to 16 ounces of the liquid every hour for about 4 to 8 hours.

If your child has trouble drinking enough of the liquid, starts to feel sick or vomit, or is too young to follow instructions, the doctor might recommend using a nasogastric (NG) tube.

To start a clean out using an NG tube, a doctor or nurse puts a small, flexible tube through your child’s nose, down the throat, and into the stomach. An I.V. line (a needle with a tube attached) may be placed in your child’s arm to give fluids or medicine during the cleanout.

When the NG tube is in place and tube placement has been verified, the nurse connects it to a drip bag. This bag is filled with a solution that has laxatives and electrolytes, such as GoLYTELY. A machine then pumps the solution directly into your child’s stomach at a steady pace.

Your child has to stop eating solid foods during the clean out. But they might be able to have a clear liquid diet. Those are foods you can see through, like popsicles, gelatin, and broth.

When the medicine starts to work, your child will have large, watery stools. Your child will need to go to the bathroom often and urgently. Let a doctor or nurse know if your child has trouble making it to the bathroom in time. They can provide a bedside commode (portable toilet).

Your child might have some mild stomach pain, bloating, or nausea during the clean out. If your child starts to vomit, let the doctor or nurse know. They can slow down the liquid and give medicine to help with nausea and vomiting, if needed.

A full clean out may take 8 to 24 hours. It depends on which approach you and your child choose, how severe your child’s constipation is, and how well your child responds to the medicine. A nurse will monitor your child during the process. The clean out is finished when your child’s stool turns into a clear or light yellow liquid (like chicken broth).

If the clean out was done to prepare your child for a test or surgery, you’ll stay for more treatment.

If the clean out was done to relieve constipation, you’ll be able to go home after the doctor confirms that there’s no more blockage in your child’s colon. They may do an X-ray to make sure.

Talk with the doctor or nurse about how to care for your child at home after the clean out. For example, they may prescribe laxatives or stool softeners to prevent constipation in the future.

The most common side effects are stomach pain, bloating, and nausea during the clean out. Other side effects to watch for include:

• Dehydration and electrolyte imbalance. Flushing out the bowels quickly during a short time can upset the balance of fluids and minerals in your child's body. That’s why doctors and nurses will monitor your child closely for signs of a problem. Tell the doctor or nurse right away if your child seems very sleepy or tired, is dizzy, has a dry mouth, isn't urinating, or has muscle cramps or a fast heartbeat.
• Severe stomach pain, cramps, or vomiting. The large volume of liquids over a short time can overwhelm a child's stomach. If that happens, the doctor or nurse can slow down the flow of liquids. They may also give medicines to help.
• Red, irritated skin around the anus. Applying a protective ointment like petroleum jelly and using soft, wet wipes after your child has a bowel movement can help.

If your child is using an NG tube, there is a small risk of injury to the throat, airways, or lungs. Talk with the doctor or nurse about any concerns you may have and what they are doing to prevent problems.