A randomized single-blind trial of standard diet versus fiber-free diet with polyethylene glycol electrolyte solution for colonoscopy preparation.
OBJECTIVE
Colonoscopy preparation usually involves the intake of large volumes of polyethylene glycol electrolyte solution (PEG-ES) in combination with a clear-liquid diet (CLD). Liberalization of the diet might enhance the tolerance to PEG-ES without compromising the quality of the preparation. The primary aims of this study were to evaluate the efficacy and tolerability of PEG-ES given with a CLD compared with a fiber-free diet (FFD) for colonoscopy preparation. The incidence of adverse events among patients in the two diet groups was also assessed as a secondary outcome.


METHODS
This was a single-center randomized, prospective, single-blind study. A total of 200 patients undergoing colonoscopy were randomized to either CLD or FFD in addition to PEG-ES.


RESULTS
Patients in the FFD group were able to drink more PEG-ES (mean +/- SD, 3.9 +/- 0.3 L) compared with those in the CLD group (3.3 +/- 0.7 L) ( P < 0.01). The quality of the preparation was significantly better in the FFD group, with more patients having satisfactory preparations than those in the CLD group (81.4 % vs. 52.0 %; P < 0.001). Tolerance to the preparation was higher in the FFD group compared with the CLD group, with significantly more patients adhering to the FFD regimen ( P < 0.001). There were more adverse events experienced in the CLD group, with odds ratios of 1.9 for nausea (95 % confidence interval [CI] 1.0 - 3.6), 3.8 for vomiting (95 % CI 1.3 - 11.3), and 3.0 for headache (95 % CI 1.5 - 5.9).


CONCLUSIONS
FFD given with PEG-ES on the day before colonoscopy is a more effective regimen than the standard CLD regimen, and is better tolerated by patients.
Soweid
A M
AM
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. as25@aub.edu.lb
Kobeissy
A A
AA
Jamali
F R
FR
El-Tarchichi
M
M
Skoury
A
A
Abdul-Baki
H
H
El-Zahabi
L
L
El-Sayyed
A
A
Barada
K A
KA
Sharara
A I
AI
Mourad
F
F
Arabi
A
A
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods*; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage*; D004573:Electrolytes / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
D002400:Cathartics; D004043:Dietary Fiber; D004573:Electrolytes; D011092:Polyethylene Glycols