Low-residue diet for colonoscopy in veterans: Risk factors for inadequate bowel preparation and patient satisfaction and compliance

Abstract

Bowel preparation with low-residue diet (LRD) has resulted in higher patient satisfaction and similar polyp detection rates compared to conventional clear liquid diet. However, there is limited experience with LRD in veterans, in whom conditions associated with poor bowel preparation are more prevalent than the general population. To examine risk factors associated with inadequate bowel preparation, we conducted a chart review of outpatient colonoscopies at the Manhattan VA Medical Center from February 2017 to April 2018. To examine patient satisfaction and compliance, we administered an anonymous questionnaire to patients undergoing outpatient colonoscopy from March to August 2018. Patients assessed by chart review (n = 660) were 92% male with a mean age of 64 years. An adequate Boston Bowel Preparation Scale score �2 in each colonic segment was achieved in 94% of procedures. Higher BMI, diabetes, prior inadequate bowel preparation, bowel preparation duration of two days, and opioid use were associated with inadequate bowel preparation on univariable analysis. On multiple logistic regression, only higher BMI remained a predictor, with every one-unit increase associated with a 6% increased odds of poor bowel preparation. Questionnaire responses showed 84% of patients were willing to repeat LRD bowel preparation, 85% found the process easy or acceptable, and 78% reported full adherence to LRD. These findings demonstrate that bowel preparation quality, patient satisfaction, and compliance were all high among veterans using LRD.

2021 Patient Perceptions Regarding Colonoscopy Experience

“…Considerable data indicate low residue diets for part of the day before colonoscopy lead to improvement in tolerability of the bowel preparation. [21][22][23][24][25] Greater use of low residue diets during the study interval could have led to a change in the extent to which bowel preparation dominated the unpleasant aspects of the colonoscopy experience. Anecdotally, we have encountered some challenges with careful patient adherence to low residue when prescribing low residue diets outside of clinical trials in an open-access environment, and this was particularly true during the pandemic, when there were intermittent shortages of nursing personnel to make preprocedure phone calls.…”

“…Fourth, most patients were on clear liquids the day before colonoscopy. Considerable data indicate low residue diets for part of the day before colonoscopy lead to improvement in tolerability of the bowel preparation 21–25. Greater use of low residue diets during the study interval could have led to a change in the extent to which bowel preparation dominated the unpleasant aspects of the colonoscopy experience.…”

Bowel Preparations for Colonoscopy: Current Medical Practices in Pakistani Hospital Settings

“…In some circumstances where there is a high risk of insufficient cleansing, a liquid diet seems appropriate. (20,21) Dietary modifications were suggested for 20.4% of patients before the colonoscopy. The primary reason for the dietary change may be due to constipation.…”

Factors Affecting the Quality of Bowel Preparation Before Colonoscopy in Outpatient: A Prospective Observational Study

“…Colonoscopy is still a practical test for bowel diseases, but it depends on high-quality preparation before examination. Bowel preparation is a complex process that is influenced by several factors, including patient-related factors such as age, gender (Baker et al, 2019; Lee et al, 2017), body mass index (Ramprasad et al, 2020), complication (Lee et al, 2017; Mahmood et al, 2018), and patient compliance (Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, 2020), as well as other factors such as diet (Bucci et al, 2014), regimen and type of laxative taken (Dang et al, 2021; Lee et al, 2017), and the time interval between the end of taking the laxative and the beginning of examination (Bucci et al, 2014). To achieve a higher quality of bowel preparation, doctors could change the influencing factors.…”