Randomized Clinical Trial: A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy.
Dis Colon Rectum
; 62(4): 491-497, 2019 04.
Article
en En
| MEDLINE
| ID: mdl-30844973
ABSTRACT
BACKGROUND:
Clinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies.OBJECTIVE:
Our aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation.DESIGN:
This is a randomized, endoscopist-blinded, noninferiority clinical trial. SETTINGS The study was conducted at a tertiary care center. PATIENTS A total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included. INTERVENTION Participants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen. MAIN OUTCOMEMEASURES:
Primary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability.RESULTS:
Participants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89.1% vs 95.7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0.04). Low-fiber diet participants reported less fluid-intake perception (p = 0.04) and less hunger (p = 0.006), with no differences in bloating or nausea.LIMITATIONS:
The single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings.CONCLUSION:
A normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. Registered at clinicaltrials.gov NCT02401802. See Video Abstract at http//links.lww.com/DCR/A829.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Ingestión de Energía
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Fibras de la Dieta
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Neoplasias Colorrectales
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Colonoscopía
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Colon
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Dietoterapia
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Ingestión de Líquidos
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Guideline
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Screening_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Dis Colon Rectum
Año:
2019
Tipo del documento:
Article
País de afiliación:
España