Clear Liquid Versus Low-fibre Diet in Bowel Cleansing for Colonoscopy in Children: A Randomized Trial.

OBJECTIVES: In light of a paucity of data on the role of diet in colonoscopy preparation in paediatric population, the present study was designed to compare the effectiveness of clear liquid and low-fibre diets for breakfast and lunch on the day preceding colonoscopy in children. METHODS: This prospective, randomised trial was conducted at the Department of Paediatric Gastroenterology and Nutrition in Warsaw, Poland. Eligible patients, referred for colonoscopies, were 6 to 18 years old. Patients were randomly divided into 2 groups: the first received a clear liquid diet and the second a low-fibre diet on the day before colonoscopy. In the afternoon, all participants were asked to drink polyethylene glycol with electrolytes at a dose of 66 mL/kg to a maximum of 4 L. The effectiveness of bowel cleansing was measured using the Boston Bowel Preparation Scale (BBPS). The preparation tolerance was assessed by parents and children using a visual analogue scale. Adverse effects were reported. RESULTS: In total, 184 patients were enrolled. Of those, 96 received the clear liquid diet and 88-the low-fibre diet. The mean age of both groups was 15 years. There were no differences between the 2 study groups in age, weight, and sex, as well as in total BBPS score (BBPS ≥ 5 96.6% vs 95.1%, P = 0.5). The frequency of adverse effects was similar in both groups; nausea was the most common (P = 0.8). CONCLUSIONS: Clear liquid and low-fibre diets administered to children the day before colonoscopy demonstrated similar bowel cleansing effectiveness.

Narrow­band imaging and white­light endoscopy for detection of colorectal polyps: a randomized study.

INTRODUCTION: Narrow­band imaging (NBI) is a new, promising technique that might be helpful in the detection of colorectal polyps during colonoscopy. OBJECTIVES: The aim of the study was to compare the usefulness of NBI with white­light endoscopy (WLE) for the detection of polyps as well as to determine the distribution of missed polyps. PATIENTS AND METHODS: This was a randomized controlled trial. A total of 253 patients were included, in whom colonoscopy was performed twice: 126 patients underwent 2 procedures using white light, while in 127 patients NBI was used for the second procedure. The number and location of colorectal polyps identified during the second colonoscopy were recorded. RESULTS: No significant differences were observed in the rates of detected polyps, adenomas, and hyperplastic polyps between the WLE and NBI groups (38 vs. 48, P <0.2051; 11 vs. 19, P < 0.12; 27 vs. 29, P <0.4647, respectively). A half of all missed adenomas (n = 15) were found in the cecum and the ascending colon. CONCLUSIONS: WLE and NBI seem to be equally effective in identifying missed adenomas and hyperplastic polyps during colonoscopy. Repeated endoscopy of the cecum and ascending colon may significantly increase the number of detected adenomas.