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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.
Alvarez-Gonzalez, Marco A; Pantaleon, Miguel A; Flores-Le Roux, Juana A; Zaffalon, Diana; Amorós, Jaume; Bessa, Xavier; Seoane, Agustin; Pedro-Botet, Juan.
Afiliação
  • Alvarez-Gonzalez MA; Department of Digestive Diseases, Hospital del Mar, Barcelona, Spain.
  • Pantaleon MA; Department of Medicine, Universitat Autònoma de Barcelona, Spain.
  • Flores-Le Roux JA; Department of Digestive Diseases, Hospital del Mar, Barcelona, Spain.
  • Zaffalon D; Department of Medicine, Universitat Autònoma de Barcelona, Spain.
  • Amorós J; Department of Medicine, Universitat Autònoma de Barcelona, Spain.
  • Bessa X; Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain.
  • Seoane A; Department of Digestive Diseases, Hospital del Mar, Barcelona, Spain.
  • Pedro-Botet J; Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Spain.
Dis Colon Rectum ; 62(4): 491-497, 2019 04.
Article em En | MEDLINE | ID: mdl-30844973
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 OUTCOME MEASURES: 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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ingestão de Energia / Fibras na Dieta / Neoplasias Colorretais / Colonoscopia / Colo / Dietoterapia / Ingestão de Líquidos Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline / Screening_studies Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ingestão de Energia / Fibras na Dieta / Neoplasias Colorretais / Colonoscopia / Colo / Dietoterapia / Ingestão de Líquidos Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline / Screening_studies Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article