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The impact of diet liberalization on bowel preparation for colonoscopy.

ABSTRACT: Background and study aims?Dietary restrictions are integral to colonoscopy preparation and impact patient satisfaction. Utilizing split-dose, lower-volume polyethylene glycol 3350-electrolyte solution (PEG-ELS), this study compared colon preparation adequacy of a low-residue diet to clear liquids using a validated grading scale. Patients and methods?This was a prospective, randomized, single-blinded, single-center non-inferiority study evaluating diet the day prior to outpatient colonoscopy. Subjects were randomized to a Low-Residue diet for breakfast and lunch, or Clears only. All subjects received split dose PEG-ELS.?The primary endpoint was preparation adequacy using the Boston Bowel Preparation Scale (BBPS), with adequate defined as a score?>?5.?Secondary endpoints included mean BBPS scores for the entire colon and individual segments, satisfaction, adverse events, polyp and adenoma detection rates, and impact on sleep and daily activities. Results?Final analysis included 140 subjects, 72 assigned to Clears and 68 to Low-Residue. The Low-Residue diet was non-inferior to Clears (risk difference?=?-?5.08?%, P?=?0.04) after adjusting for age. Mean colon cleansing scores were not significantly different overall and for individual colonic segments. Satisfaction with the Low-Residue diet was significantly greater (P?=?0.01). The adenoma detection rate was not statistically significantly different between study groups, but the number of adenomas detected was significantly greater with Clears (P?=?0.01). Adverse events and impact on sleep and activities did not differ significantly between diet arms. Conclusions?A low-residue diet for breakfast and lunch the day prior to colonoscopy was non-inferior to clear liquids alone for achieving adequate colon cleansing when using split dose PEG-ELS.

SUBMITTER: Walter J

PROVIDER: S-EPMC5375955 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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The impact of diet liberalization on bowel preparation for colonoscopy.

Walter James J Francis Gloria G Matro Rebecca R Kedika Ramalinga R Grosso Rachael R Keith Scott W SW Kastenberg David D

Endoscopy international open 20170401 4

<b>Background and study aims</b> Dietary restrictions are integral to colonoscopy preparation and impact patient satisfaction. Utilizing split-dose, lower-volume polyethylene glycol 3350-electrolyte solution (PEG-ELS), this study compared colon preparation adequacy of a low-residue diet to clear liquids using a validated grading scale. <b>Patients and methods</b> This was a prospective, randomized, single-blinded, single-center non-inferiority study evaluating diet the day prior to outpatient co ...[more]

PMID: 28382323

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Project description:BackgroundClinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies.ObjectiveOur aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation.DesignThis is a randomized, endoscopist-blinded, noninferiority clinical trial.SettingsThe study was conducted at a tertiary care center.PatientsA total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included.InterventionParticipants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen.Main outcome measuresPrimary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability.ResultsParticipants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89.1% vs 95.7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0.04). Low-fiber diet participants reported less fluid-intake perception (p = 0.04) and less hunger (p = 0.006), with no differences in bloating or nausea.LimitationsThe single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings.ConclusionA normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. Registered at clinicaltrials.gov: NCT02401802. See Video Abstract at http://links.lww.com/DCR/A829.

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The impact of diet liberalization on bowel preparation for colonoscopy.

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The impact of diet liberalization on bowel preparation for colonoscopy.

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