Michael Tyshkov, MD

New Jersey Office: (908) 273-7745
Staten Island Office: (718) 226-5619
Brooklyn Office: (718) 372-8402

A Guide to the procedures

Please take the time to review our procedure details in detail. 

Doctor Examining a Child

Endoscopy/Colonoscopy Procedures

For any procedure under anesthesia, no food or drink should be taken after midnight (there are some exceptions for very young children, e.g., breastfeeding; to be discussed in advance). You may take a few sips of water or a clear juice 3-4 hours before the procedure. During your visit, you may be offered an endoscopy as a diagnostic test (and on some occasions, as a therapeutic approach as well).

In both cases, a small video camera is introduced into the gastrointestinal tract and is advanced to reach as far as the duodenum from above, or the colon from below. After a visual examination of the surface, a few samples of the mucosa, the inner (superficial) lining are obtained for pathological examination under a microscope. Once photos are also taken, the video camera is withdrawn. The average time for an EGD is 3-5 minutes and 15-20 minutes for a colonoscopy with occasional variations.

Learn More Upper Endoscopy (EGD) Learn More About Colonoscopy

Before the procedure, you will also meet with a pediatric anesthesiologist, and he/she will discuss the nature of the anesthesia necessary for the procedure. Endoscopy is considered to be a very safe test, and the complication rate for both the procedure and anesthesia is a small fraction of a percent. The following sites feature videos about the procedures:

GI Kids CartoonGI

Preparation for the Procedures

Only the colonoscopy requires bowel preparation to ready the bowel for surgery or a procedure by clearing it of all solid matter. Please follow these Instructions. Begin the bowel prep one day before your scheduled procedure. To prepare you will need these items from a pharmacy: MiraLAX powder and Dulcolax tablets, 5 milligrams, or Senokot liquid (if your child can't swallow tablets). 

The total dose of each of those laxatives will be specified for your child's age (see below). There may be generic store brands of these products that cost less (ask your pharmacist.) One day before your test:

Drink only clear liquids (as below). Avoid all red or purple colored liquids. Do not eat any food after midnight until your test is done (there are some modifications for very young children; please discuss with Dr. Tyshkov). You may take a few sips of water or a clear juice for 3-4 hours before the procedure.

Please reschedule the procedure if your child is having any signs of a respiratory tract infection, fever, etc. Please reach out to Dr. Tyshkov if there are any concerns.

Clear Liquids:

  • Water, Strained Fruit Juices (No Pulp)
  • Popsicles
  • Soft drinks, Gatorade, Clear Broth, or Bouillon
  • Jell-O, Kool-Aid
  • Coffee or Tea (No Milk or Cream)

The bowels are "clean" when there is only pale yellow fluid coming out. You may start your preparation earlier, but the schedule below is chosen for the children who choose to attend a half day of school on the day before the procedure.

1:00 p.m.: Take Dulcolax tablets or Senokot with a drink of clear liquids. If your child's weight is less than 44 lbs. (20kg), they may not take Dulcolax or Senokot.

46 - 66 lbs. (21-30 kg) ...10 mg of Dulcolax or 3 Teaspoons of Senokot
Over 66 lbs....................15 mg of Dulcolax or 6 Teaspoons Senokot

Learn About Over-the-Counter Medicine Sickening Children

2:00 PM: Mix the MiraLAX in a clear liquid of choice to dissolve the powder. Most people prefer to drink the liquid chilled, so you may want to place it in the refrigerator. Start to drink the MiraLAX. It is better to drink one glass every 15-30 minutes, and finish within 2-4 hours. Some children can't drink it so fast. Do not force your child to drink! Allow them to drink slowly and ensure that they drink all of the liquid.

22 lbs. (10kg) - 27 lbs.(12kg)......... 45 Grams (3 Tablespoons) Mix to 24 oz. of Water
28 lbs. (13kg) - 49 lbs.(22kg).........60 Grams (4 Tablespoons) Mix to 32 oz. of Water
50 lbs. (23kg) - 71 lbs.( (32kg).......90 Grams (6 Tablespoons) Mix to 48 oz. of Water
72 lbs. (33kg) - 93 lbs.( (42kg).......120 Grams (8 Tablespoons) Mix to 64 oz. of Water
94 lbs. (43kg) & Up........................150 Grams (10 Tablespoons) Mix to 64 oz. of Water

On the morning of the procedure, you may gargle but do not swallow any liquid.

Morning of the Procedure
For colonoscopy only: If there is no clear liquid stool by 8:00 - 10:00 p.m., you should give a fleet enema (adult size) after 10:00 p.m. or in the early morning. If you are to take your morning medicines, please take them with small sips of water only. Bring all medicines you usually take (in the original containers) to the hospital with you.

You may be told to arrive 1 hour before your test is scheduled so that staff can get you ready. Expect to be here for 2 to 4 hours for your test and recovery time. Talk to your doctor or nurse if you have any questions or concerns. If you cancel your procedure, please let us know as soon and as far in advance as possible.

Esophageal pH monitoring (Bravo test)

A small capsule, about the size of a gel cap, is temporarily attached to the wall of the esophagus during an upper endoscopy. The capsule measures pH levels in the esophagus and transmits readings by radio telecommunications to a receiver (about the size of a pager) worn on your belt or waistband. The receiver has several buttons on it that you will press to record symptoms of GERD such as heartburn (the nurse will tell you what symptoms to record). You will be asked to maintain a diary to record certain events such as when you start and stop eating and drinking, when you lie down, and when you get back up. This will be explained by the nurse. You must stop taking any acid suppressive medications you use for 3 days before the study unless you have been advised by your doctor not to.  The capsule will stay in the esophagus for about 3 days and will be passed in a stool.  It does not need to be removed.  It is a save test with extremely low risk of side effects.  Some children- likely only because they are aware, that they have a little chip placed in their esophagus, complain of some mid-chest discomfort following the procedure.  Give your child a spoon of an ice cream or something cold..or something hot, along with a reassurance that their discomfort is temporary.  You will be asked to bring the receiver back to the endoscopy suite or your doctor office after 48 hours of monitoring.

Anorectal manometry

Anorectal manometry is a test performed to evaluate patients with constipation or fecal incontinence. This test measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements. There is no preparation for the test except an adult size fleet enema before the study.  It is pain free, does not require any anesthesia, and last about 30 min.  It is done in the endoscopy unite of Staten Island University Hospital.

Capsule enteroscopy study

Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of your digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule you swallow. Most of teenage children able to swallow this capsule with a sip of water, younger children often can not and the capsule is placed inside their intestine through the upper endoscopy.  Children are discharged home with a monitor on a belt, adjusted over their waist, and it requires about 12 hours to complete this study.  The capsule may be visible in a stool next day, but it does not need to be recovered.  Liquid diet after lunch on a day before the test, and no food no drinks  AM the day of the test.  Liquid diet during monitoring.

Staten Island and Brooklyn Locations

The procedures are performed on Wednesdays and scheduled through our Staten Island Office, by Dr. Tyshkov's office assistants. The telephone number is (718) 226-5619. You will be contacted over the phone to confirm the details. If you have any questions, please contact our office during the hours of 9:00 a.m. - 4:30 p.m. You may always reach Dr. Tyshkov or his partner, Dr. Hample, at the same telephone number.

The endoscopy unit is located at Staten Island University Hospital North campus. Call the number listed below a day in advance (Tuesday) around 2:00 p.m. - 4:00 p.m. to confirm your visit and to get a specific time for your arrival and the procedure.

Staten Island University Hospital North
(718) 226-9260
2nd Floor, Endoscopy Suite
475 Seaview Avenue
Staten Island, NY 10305

New Jersey Patients

St. Barnabas Ambulatory Surgical Center, 2nd Floor
200 S. Orange Avenue, Livingston, NJ 07039
(973) 322-7000

Dr. Tyshkov's assistant, Fiona, will communicate for all scheduling-related questions. The nurse at St. Barnabas will call you the day before with the time. If you do not receive a phone call, please call (973) 322-7000. You may also reach Dr. Tyshkov through our service at (718) 226-5619.

Doctor Checking a Patient's Temperature