White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

Dwyer, Jeremy; Tan, Jonathan Y. C.; Paul, Eldho; Bunn, Catherine; Mangira, Dileep; Secomb, Robyn

doi:10.1002/jgh3.12006

Cited by 8 publications

(11 citation statements)

References 32 publications

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“…Jeremy et al . [ 16 ] found that as an option for bowel preparation, white diets were high in calories, can be easily obtained and identified and were preferred by patients. In addition, white diets did not reduce bowel preparation quality.…”

Section: Discussionmentioning

confidence: 99%

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

Jiao

Wang

Zhao

et al. 2020

Saudi J Gastroenterol

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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.

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Section: Discussionmentioning

confidence: 99%

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

Jiao

Wang

Zhao

et al. 2020

Saudi J Gastroenterol

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“…The analysis showed that a total of 5 studies (N = 933) involved the indicator of hunger. [ 13 , 15 , 19 , 21 , 26 ] In the pooled analysis, the hunger sensation in the CLD group (52.5%, 244/465) was significantly more severe than that in the LRD group (36.8%, 172/468). (RR, 1.64, 95% CI, 1.12–2.39; P < .05; I 2 = 81.4%, P < .01) (Fig.…”

Section: Resultsmentioning

confidence: 97%

Low-residue versus clear liquid diet before colonoscopy

Chen

Wang

et al. 2020

Medicine

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Great value in the early identification and treatment of adenomatous polyps or early canceration using colonoscopy has been recognized. A clear colonoscopic vision brought by good intestinal preparation will become crucial. Several studies have completed using the low-residue diet (LRD) versus a clear liquid diet (CLD) the day before colonoscopy that presenting contradictory results. Therefore, a more comprehensive and updated meta-analysis is needed to summarize the findings on the effects of LRD and CLD on intestinal preparation and the quality of coloscopy. The comprehensive search was performed in PubMed/MEDLINE, Scopus, Cochrane databases (February 2020). LRD vs CLD before colonoscopy were included in this study. Mantel-Haenszel or DerSimonian and Laird models with the relative risk (RR) to evaluate differences in intestinal preparation, tolerance, readiness to repeat preparation, detected of a polyp, and overall adverse reactions. Total 16 studies (N = 3413) were eligible. Patients with LRD compared with CLD indicated significantly better of tolerability (RR 0.92;95% CI,0.85–0.99; P < .05) and willingness to repeat intestinal preparation (RR 0.86; 95% CI 0.79–0.93; P < .05), but no differences with adequate intestinal preparations, detected polyp or overall adverse reactions (all P > .05). Patients with LRD the day before colonoscopy show better tolerance and willingness to repeat intestinal preparation, and no difference with adequate intestinal preparations compared with CLD, but the recommended level of evidence is weak. However, in terms of the detection rate of intestinal adenomas, the LRD group is not weaker than the CLD group, for its evidence level is high, and can significantly reduce the hunger experience of patients.

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“…PEG works as an osmotic laxative that is non‐absorbed in the GI tract. In addition, the PEG+SPMC preparation contains two active ingredients with different mechanisms of action; sodium picosulfate is a stimulant laxative, and magnesium oxide combined with citric acid acts as an additional osmotic laxative 19,26 . In comparison, the 1 L PEG+Asc preparation contains PEG in both the doses (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Following randomization, all enrolled participants were either mailed their allocated bowel preparation product or collected this in person. They were given written bowel preparation instructions and were asked to follow a “white diet” 10 , 19 for 2 days prior to their colonoscopy. The white diet consists of a range of low‐residue white or cream‐colored foods, such as milk, white yoghurt, and white bread.…”

Section: Methodsmentioning

confidence: 99%

Split‐dose 1 L polyethylene glycol (PEG) with ascorbate is non‐inferior to split‐dose PEG with sodium picosulfate and magnesium citrate with similar tolerability: a randomized study

et al. 2021

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Background and Aim Post‐marketing studies comparing low‐volume polyethylene glycol (PEG)‐based regimens are limited. This randomized study aimed to compare the efficacy and tolerability of a novel 1‐L low‐volume PEG‐based preparation: 1 L PEG+Asc (PEG3350, sodium ascorbate, sodium sulfate, ascorbic acid, sodium chloride, and potassium chloride) with PEG+SPMC (PEG3350, sodium chloride, potassium chloride and sodium sulfate, sodium picosulfate, magnesium oxide, citric acid, and aspartame), prior to routine colonoscopy at an Australian tertiary referral center. Methods Outpatients undergoing colonoscopy were randomized to receive either split‐dose 1 L PEG+Asc or split‐dose PEG+SPMC. Bowel preparation quality using the Boston Bowel Preparation Scale (BPPS), modified Aronchick scores, procedure time, cecal intubation, and adenoma detection rates were recorded. Patient compliance and tolerability were captured using a standardized questionnaire. Results A total of 173 patients were randomized, of whom 164 completed the study and were allocated to 1 L PEG+Asc (n = 82) or PEG+SPMC (n = 82). Non‐inferiority of 1 L PEG+Asc was demonstrated with 89% achieving successful preparation (total BPPS ≥6 and each sub‐score ≥2) compared with 85.4% in the PEG+SPMC group, resulting in an estimated difference of 3.7% (95% CI −6.6% to 13.9%). The median BBPS was non‐inferior in all colonic segments with 1 L PEG+Asc (BBPS 3 [interquartile range 2–3]) vs PEG+SPMC (BBPS 2 [interquartile range 2–3]). More 1 L PEG+Asc patients reported moderate to severe nausea (P = 0.028), but overall tolerability was similar. Conclusions The quality of bowel preparation achieved with 1 L PEG+Asc is non‐inferior to that with PEG+SPMC, with similar tolerability outcomes. Further studies are required in patients at risk of suboptimal bowel preparation.

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White Diet with split‐dose Picosalax is preferred, better tolerated, and non‐inferior to day‐before clear fluids with polyethylene glycol plus sodium picosulfate‐magnesium citrate for morning colonoscopy: A randomized, non‐inferiority trial

Cited by 8 publications

References 32 publications

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

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

Low-residue versus clear liquid diet before colonoscopy

Split‐dose 1 L polyethylene glycol (PEG) with ascorbate is non‐inferior to split‐dose PEG with sodium picosulfate and magnesium citrate with similar tolerability: a randomized study

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