title: The impact of diet liberalization on bowel preparation for colonoscopy.
abstract: Background and study aimsDietary restrictions are integral to colonoscopy preparation and impact patient satisfaction. Utilizing split-dose, lower-volume polyethylene glycol 3350-electrolyte solution (PEG-ELS), this study compared colon preparation adequacy of a low-residue diet to clear liquids using a validated grading scale.Patients and methodsThis was a prospective, randomized, single-blinded, single-center non-inferiority study evaluating diet the day prior to outpatient colonoscopy. Subjects were randomized to a Low-Residue diet for breakfast and lunch, or Clears only. All subjects received split dose PEG-ELS. The primary endpoint was preparation adequacy using the Boston Bowel Preparation Scale (BBPS), with adequate defined as a score > 5. Secondary endpoints included mean BBPS scores for the entire colon and individual segments, satisfaction, adverse events, polyp and adenoma detection rates, and impact on sleep and daily activities.ResultsFinal analysis included 140 subjects, 72 assigned to Clears and 68 to Low-Residue. The Low-Residue diet was non-inferior to Clears (risk difference = - 5.08 %,P= 0.04) after adjusting for age. Mean colon cleansing scores were not significantly different overall and for individual colonic segments. Satisfaction with the Low-Residue diet was significantly greater (P= 0.01). The adenoma detection rate was not statistically significantly different between study groups, but the number of adenomas detected was significantly greater with Clears (P= 0.01). Adverse events and impact on sleep and activities did not differ significantly between diet arms.ConclusionsA low-residue diet for breakfast and lunch the day prior to colonoscopy was non-inferior to clear liquids alone for achieving adequate colon cleansing when using split dose PEG-ELS.
authors.affiliation: Department of Gastroenterology, Cooper University, Mount Laurel, New Jersey, United States.
authors.forename: James
authors.initials: J
authors.lastname: Walter
authors.affiliation: Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States.
authors.forename: Gloria
authors.initials: G
authors.lastname: Francis
authors.affiliation: Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Matro
authors.affiliation: Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States.
authors.forename: Ramalinga
authors.initials: R
authors.lastname: Kedika
authors.affiliation: Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States.
authors.forename: Rachael
authors.initials: R
authors.lastname: Grosso
authors.affiliation: Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Keith
authors.affiliation: Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States.
authors.forename: David
authors.initials: D
authors.lastname: Kastenberg