Low-residue versus clear liquid diet before colonoscopy

Chen, Engeng; Chen, Li; Wang, Fei; Zhang, Wei; Cai, Xianlei; Cao, Gaoyang

doi:10.1097/md.0000000000023541

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…To our best knowledge, this is the first real‐world study on this issue. LRDs are known to have similar efficacy for bowel preparation and better tolerability than clear liquid diets 17,18,23,24 . Furthermore, Chen et al 17 performed an updated meta‐analysis of 13 controlled trials that compared 1‐day LRD and clear liquid diets, and the results strongly suggested the feasibility of a 1‐day LRD.…”

Section: Discussionmentioning

confidence: 99%

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

Yeh

Hsiao

et al. 2022

Adv in Digestive Medicine

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A low-residue diet (LRD) is recommended as part of bowel preparation before a colonoscopy. However, the optimal duration of the LRD is unclear. A retrospective cross-sectional study was therefore conducted at E-Da Dachang Hospital. We compared bowel preparations using the Aronchick score and other quality metrics during two consecutive periods: May 2019 to December 2019 (3-day LRD) and January 2020 to August 2020 (1-day LRD). A total of 2823 patients were enrolled (1592 in the 3-day LRD group and 1231 in the 1-day LRD group). The most common bowel cleansing agent was sodium picosulfate and magnesium citrate (SPMC, 84.2%), followed by polyethylene glycol (PEG, 10.0%) and sodium phosphate (5.8%). Compared with patients in the 3-day LRD group, patients in the 1-day LRD group had higher SPMC use (88.1% vs 81.3%, P < .001) and supplemental laxative use (25.9% vs 19.3%, P < .001).The proportion of adequate bowel preparation (84.2% vs 85.1%, P = .563), cecal intubation rate, adenoma detection rate, and right-side adenoma detection rate were not significantly different between 1-day LRD and 3-day LRD groups. More advanced adenomas (5.9% vs 3.4%, P = .002) and sessile serrated lesions (8.9% vs 6.3%, P = .014) were observed in the 1-day LRD group. In addition, the types of laxatives (SPMC, sodium phosphate, and PEG) and the use of supplemental laxatives did not affect bowel preparation scores. In conclusion, a 1-day LRD led to bowel preparation similar to that achieved through a 3-day LRD regardless of the type of primary cleansing agent or the use of supplemental laxatives.

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Section: Discussionmentioning

confidence: 99%

“…However, a consensus on the best timing and duration of the LRD has not been achieved. Although an LRD has exhibited better tolerability without impairing the bowel preparation compared with a clear liquid diet, [16][17][18] a prolonged LRD can potentially hinder the willingness of patients to receive a colonoscopy.…”

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confidence: 99%

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

Yeh

Hsiao

et al. 2022

Adv in Digestive Medicine

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“…On the day before the colonoscopy, two meta-analyses compared a low-residue diet to a clear liquid diet, with both arms using the same laxative. When compared to a clear liquid diet, Nguyen et al [ 33 ] discovered that a low residue diet was associated with better tolerability (OR = 1.92, 95%CI 1.36-2.70, P < 0.01) and higher willingness to repeat bowel preparation (OR = 1.86, 95%CI 1.34-2.59, P < 0.01). However, no differences in adequate bowel cleansing (OR = 1.21, 95%CI 0.64-2.28, P = 0.58) or adverse event incidence (OR = 0.88, 95%CI 0.58-1.35, P = 0.57) were found[ 33 ].…”

Section: Factors Influencing the Quality Of Bowel Preparationmentioning

confidence: 99%

“…When compared to a clear liquid diet, Nguyen et al [ 33 ] discovered that a low residue diet was associated with better tolerability (OR = 1.92, 95%CI 1.36-2.70, P < 0.01) and higher willingness to repeat bowel preparation (OR = 1.86, 95%CI 1.34-2.59, P < 0.01). However, no differences in adequate bowel cleansing (OR = 1.21, 95%CI 0.64-2.28, P = 0.58) or adverse event incidence (OR = 0.88, 95%CI 0.58-1.35, P = 0.57) were found[ 33 ]. Another meta-analysis, this time by Avalos et al [ 34 ], compared a low-residue diet or a regular diet to a clear liquid diet.…”

Section: Factors Influencing the Quality Of Bowel Preparationmentioning

confidence: 99%

Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

Shahini¹,

Sinagra²,

Vitello³

et al. 2023

World J Gastroenterol

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Adequate bowel cleansing is critical for a high-quality colonoscopy because it affects diagnostic accuracy and adenoma detection. Nevertheless, almost a quarter of procedures are still carried out with suboptimal preparation, resulting in longer procedure times, higher risk of complications, and higher likelihood of missing lesions. Current guidelines recommend high-volume or low-volume polyethylene glycol (PEG)/non-PEG-based split-dose regimens. In patients who have had insufficient bowel cleansing, the colonoscopy should be repeated the same day or the next day with additional bowel cleansing as a salvage option. A strategy that includes a prolonged low-fiber diet, a split preparation regimen, and a colonoscopy within 5 h of the end of preparation may increase cleansing success rates in the elderly. Furthermore, even though no specific product is specifically recommended in the other cases for difficult-to-prepare patients, clinical evidence suggests that 1-L PEG plus ascorbic acid preparation are associated with higher cleansing success in hospitalized and inflammatory bowel disease patients. Patients with severe renal insufficiency (creatinine clearance < 30 mL/min) should be prepared with isotonic high volume PEG solutions. Few data on cirrhotic patients are currently available, and no trials have been conducted in this population. An accurate characterization of procedural and patient variables may lead to a more personalized approach to bowel preparation, especially in patients undergoing resection of left colon lesions, where intestinal preparation has a poor outcome. The purpose of this review was to summarize the evidence on the risk factors influencing the quality of bowel cleansing in difficult-to-prepare patients, as well as strategies to improve colonoscopy preparation in these patients.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

2021 Patient Perceptions Regarding Colonoscopy Experience

Vemulapalli

Lahr

Rex

2022

Journal of Clinical Gastroenterology

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Goal: We sought to document patient perceptions in 2021 regarding colonoscopy experience and potential deterrents to repeat colonoscopy. Background and Aim: Bowel preparation has been previously considered by patients to be the worst part of a colonoscopy. Materials and Methods: We conducted a prospective survey of consecutive patients age 18 years and older who had just completed colonoscopy at 2 outpatient endoscopy centers at a tertiary academic hospital. The short survey was conducted in the recovery area. The main outcome measure was patient perceptions of the worst part of their colonoscopy experience and which factor would most deter them from a future colonoscopy. Results: Four hundred patients completed the survey of 405 approached. Average patient age was 64 years, and 48% were women. Seventy-five percent of patients used low-volume preparations. Bowel preparation was considered the worst part of colonoscopy by 71% of patients. Women were more likely to choose laxatives as the worst part of a colonoscopy. Bowel preparation was chosen most often (55%) as the most likely deterrent to a future colonoscopy. There were minimal differences in responses between those receiving low-volume versus high-volume (4 L) preparations. Conclusion: Bowel preparation remains the worst part of the colonoscopy experience for patients, and the most likely deterrent to future colonoscopy.

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Low-residue versus clear liquid diet before colonoscopy

Cited by 9 publications

References 28 publications

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

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

Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

2021 Patient Perceptions Regarding Colonoscopy Experience

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