Comparison of the effect of 1-day and 2-day low residue diets on the quality of bowel preparation before colonoscopy

Abstract

Background/Aim: Low residue diet (LRD) has a similar quality of bowel preparation with clear liquid diet before colonoscopy, but improved patient tolerance. However, the optimal LRD duration is still controversial. In this study, we have compared the effect of a 1-day LRD and 2-day LRD on the quality of bowel preparation and patient tolerance. Patients and Methods: Our prospective, randomized, single-blind trial, single-blind, trial compared two dietary regimens administered the day before colonoscopy. All patients were administered PEG-ES and simethicone for bowel preparation. The primary outcome measure was bowel preparation quality. The secondary outcome measures were insertion time, withdrawal time, polyp detection rate, patient tolerance, and willingness to use the same diet for bowel preparation again. Bowel preparation quality was evaluated using the Boston bowel preparation scale (BBPS). Patient tolerance was evaluated using a hunger-comfort scale. Results: There was no significant difference in bowel preparation quality between the 2 groups. The 1-day LRD group had a BBPS score of 6.48 ± 1.59 points, while the 2-day LRD group had a score of 6.42 ± 1.06 points ( P > 0.05). The groups reported similar colonoscope insertion times, withdrawal times, polyp detection rates and patient tolerance scores (hunger-comfort scores). The numbers of patients who reported that compliance as easy or very easy were 126 (78.2%) in the 1-day group versus 88 (55.0%) in the 2 day group ( P < 0.05) and the numbers who were willing to use the diet again in the future were 154 (95.7%) in the 1-day group versus 131 (81.9%) in the 2 day group ( P < 0.05). Conclusion: LRD duration (1 day or 2 days) had no significant effect on bowel preparation quality. Patients in the 1-day LRD group had higher tolerance and satisfaction levels than patients in the 2-day LRD group. However, overall satisfaction was higher with the 1-day LRD group than with the 2-day LRD group.

A single‐center retrospective study comparing 1‐day and 3‐day low‐residue diets for bowel preparation

“…Some patients in the 3‐day LRD group may not have been able to tolerate the prolonged restricted diets, whereas some patients in the 1‐day LRD group may have voluntarily extended the length of the LRD because of fear of poor preparation. However, our results are in line with those of previous randomized controlled trials in which adherence was evaluated 19–21 . In addition, to minimize bias, only the first exam was included for patients with multiple exams during the study period.…”

“…In addition, clinicians may assume that a 1‐day LRD is inadequate for patients with chronic constipation or previous poor bowel preparation. However, several previous randomized trials 19–21 have provided evidence suggesting that a 1‐day LRD is at least noninferior to an LRD of longer duration. Although we did not directly evaluate patients with constipation, we analyzed the use of supplemental laxatives, including chronic use and patients who subjectively reported constipation.…”

“…In addition, the benefits of a prolonged LRD in patients may be limited 25 . Satisfaction and willingness to comply with bowel preparation substantially improve with a 1‐day LRD 20,21 …”

“…Several randomized controlled trials have suggested that the outcome of a 1‐day LRD may be comparable to that of a 3‐day LRD 19–21 . However, no real‐world studies on the impact of LRDs of different durations have been conducted.…”

“…Several randomized controlled trials have suggested that the outcome of a 1-day LRD may be comparable to that of a 3-day LRD. [19][20][21] However, no real-world studies on the impact of LRDs of different durations have been conducted. At our institution, determining the optimal duration of an LRD before a colonoscopy was included in a quality improvement program, and after a 2-month trial and internal evaluation, we shifted the standard recommendation from a 3-day LRD to a 1-day LRD in 2020.…”