Controlled Dietary Restriction with a Prepackaged Low-Residue Diet before Colonoscopy Offers Better-Quality Bowel Cleansing and Allows the Use of a Smaller Volume of Purgatives

A Randomized Multicenter Trial

Chu Kuang Chou, Chi Yang Chang, Chun Chao Chang, Li Chun Chang, Wen Feng Hsu, Chi Yi Chen, Hsiu Po Wang, Han Mo Chiu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: Bowel preparation is burdensome, and less-demanding preparation procedures are needed. Few studies have investigated the effects of low-residue diet and prepackaged low-residue diet in combination with low-volume polyethylene glycol-electrolyte lavage solution during colonoscopy preparation. OBJECTIVE: We compared self-prepared low-residue diets with prepackaged low-residue diets in combination with low-volume polyethylene glycol. DESIGN: This was a single-blinded, 3-arm, multicenter, randomized controlled trial. SETTING: Colonoscopies were conducted in outpatient settings at 3 centers in Taiwan. PATIENTS: The study included 180 patients (age range, 20-75 years) who were scheduled for colonoscopy. INTERVENTIONS: Three groups were compared: group A included self-prepared, 1-day, low-residue diets with a same-day 2.0-L single-dose of polyethylene glycol; group B included prepackaged low-residue diets plus 2.0 L of polyethylene glycol; and group C included prepackaged low-residue diets plus 1.5 L of polyethylene glycol. MAIN OUTCOME MEASURES: The outcome measures were adherence, bowel-cleansing level, and patient satisfaction. RESULTS: One third of the subjects in group A, but none in the prepackaged low-residue diets groups, violated the dietary restrictions. The proportion of right-segment preparation failure was 15.0%, 1.7%, and 6.7% (p = 0.025). Accordingly, treatment B was superior to A (p = 0.008). Among subjects violating the low-residue diets guideline, the right-segment preparation failure rate was 25%. According to a multivariate analysis, low-residue diet compliance (adjusted OR = 6.55 (95% CI, 1.83-23.43)) and BMI were predictors of right-sided preparation adequacy, but the volume of polyethylene glycol ingested was not a predictor. Compared with group A, a greater proportion of subjects in groups B and C reported satisfaction. LIMITATIONS: Patients with high BMI and severe constipation were excluded from this study. This study included only an Asian population. CONCLUSIONS: The prepackaged low-residue diet provides excellent adherence, better bowel cleansing, and a better experience than a self-prepared low-residue diet. With good dietary compliance, 1.5 L of polyethylene glycol provides effective preparation.

Original languageEnglish
Pages (from-to)975-983
Number of pages9
JournalDiseases of the Colon and Rectum
Volume59
Issue number10
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Cathartics
Colonoscopy
Multicenter Studies
Diet
Therapeutic Irrigation
Constipation
Patient Satisfaction
Taiwan
Electrolytes
Compliance

Keywords

  • Bowel preparation
  • Colonoscopy
  • Prepackaged low-residue diet

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Controlled Dietary Restriction with a Prepackaged Low-Residue Diet before Colonoscopy Offers Better-Quality Bowel Cleansing and Allows the Use of a Smaller Volume of Purgatives : A Randomized Multicenter Trial. / Chou, Chu Kuang; Chang, Chi Yang; Chang, Chun Chao; Chang, Li Chun; Hsu, Wen Feng; Chen, Chi Yi; Wang, Hsiu Po; Chiu, Han Mo.

In: Diseases of the Colon and Rectum, Vol. 59, No. 10, 01.10.2016, p. 975-983.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Bowel preparation is burdensome, and less-demanding preparation procedures are needed. Few studies have investigated the effects of low-residue diet and prepackaged low-residue diet in combination with low-volume polyethylene glycol-electrolyte lavage solution during colonoscopy preparation. OBJECTIVE: We compared self-prepared low-residue diets with prepackaged low-residue diets in combination with low-volume polyethylene glycol. DESIGN: This was a single-blinded, 3-arm, multicenter, randomized controlled trial. SETTING: Colonoscopies were conducted in outpatient settings at 3 centers in Taiwan. PATIENTS: The study included 180 patients (age range, 20-75 years) who were scheduled for colonoscopy. INTERVENTIONS: Three groups were compared: group A included self-prepared, 1-day, low-residue diets with a same-day 2.0-L single-dose of polyethylene glycol; group B included prepackaged low-residue diets plus 2.0 L of polyethylene glycol; and group C included prepackaged low-residue diets plus 1.5 L of polyethylene glycol. MAIN OUTCOME MEASURES: The outcome measures were adherence, bowel-cleansing level, and patient satisfaction. RESULTS: One third of the subjects in group A, but none in the prepackaged low-residue diets groups, violated the dietary restrictions. The proportion of right-segment preparation failure was 15.0{\%}, 1.7{\%}, and 6.7{\%} (p = 0.025). Accordingly, treatment B was superior to A (p = 0.008). Among subjects violating the low-residue diets guideline, the right-segment preparation failure rate was 25{\%}. According to a multivariate analysis, low-residue diet compliance (adjusted OR = 6.55 (95{\%} CI, 1.83-23.43)) and BMI were predictors of right-sided preparation adequacy, but the volume of polyethylene glycol ingested was not a predictor. Compared with group A, a greater proportion of subjects in groups B and C reported satisfaction. LIMITATIONS: Patients with high BMI and severe constipation were excluded from this study. This study included only an Asian population. CONCLUSIONS: The prepackaged low-residue diet provides excellent adherence, better bowel cleansing, and a better experience than a self-prepared low-residue diet. With good dietary compliance, 1.5 L of polyethylene glycol provides effective preparation.",
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AU - Chou, Chu Kuang

AU - Chang, Chi Yang

AU - Chang, Chun Chao

AU - Chang, Li Chun

AU - Hsu, Wen Feng

AU - Chen, Chi Yi

AU - Wang, Hsiu Po

AU - Chiu, Han Mo

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N2 - BACKGROUND: Bowel preparation is burdensome, and less-demanding preparation procedures are needed. Few studies have investigated the effects of low-residue diet and prepackaged low-residue diet in combination with low-volume polyethylene glycol-electrolyte lavage solution during colonoscopy preparation. OBJECTIVE: We compared self-prepared low-residue diets with prepackaged low-residue diets in combination with low-volume polyethylene glycol. DESIGN: This was a single-blinded, 3-arm, multicenter, randomized controlled trial. SETTING: Colonoscopies were conducted in outpatient settings at 3 centers in Taiwan. PATIENTS: The study included 180 patients (age range, 20-75 years) who were scheduled for colonoscopy. INTERVENTIONS: Three groups were compared: group A included self-prepared, 1-day, low-residue diets with a same-day 2.0-L single-dose of polyethylene glycol; group B included prepackaged low-residue diets plus 2.0 L of polyethylene glycol; and group C included prepackaged low-residue diets plus 1.5 L of polyethylene glycol. MAIN OUTCOME MEASURES: The outcome measures were adherence, bowel-cleansing level, and patient satisfaction. RESULTS: One third of the subjects in group A, but none in the prepackaged low-residue diets groups, violated the dietary restrictions. The proportion of right-segment preparation failure was 15.0%, 1.7%, and 6.7% (p = 0.025). Accordingly, treatment B was superior to A (p = 0.008). Among subjects violating the low-residue diets guideline, the right-segment preparation failure rate was 25%. According to a multivariate analysis, low-residue diet compliance (adjusted OR = 6.55 (95% CI, 1.83-23.43)) and BMI were predictors of right-sided preparation adequacy, but the volume of polyethylene glycol ingested was not a predictor. Compared with group A, a greater proportion of subjects in groups B and C reported satisfaction. LIMITATIONS: Patients with high BMI and severe constipation were excluded from this study. This study included only an Asian population. CONCLUSIONS: The prepackaged low-residue diet provides excellent adherence, better bowel cleansing, and a better experience than a self-prepared low-residue diet. With good dietary compliance, 1.5 L of polyethylene glycol provides effective preparation.

AB - BACKGROUND: Bowel preparation is burdensome, and less-demanding preparation procedures are needed. Few studies have investigated the effects of low-residue diet and prepackaged low-residue diet in combination with low-volume polyethylene glycol-electrolyte lavage solution during colonoscopy preparation. OBJECTIVE: We compared self-prepared low-residue diets with prepackaged low-residue diets in combination with low-volume polyethylene glycol. DESIGN: This was a single-blinded, 3-arm, multicenter, randomized controlled trial. SETTING: Colonoscopies were conducted in outpatient settings at 3 centers in Taiwan. PATIENTS: The study included 180 patients (age range, 20-75 years) who were scheduled for colonoscopy. INTERVENTIONS: Three groups were compared: group A included self-prepared, 1-day, low-residue diets with a same-day 2.0-L single-dose of polyethylene glycol; group B included prepackaged low-residue diets plus 2.0 L of polyethylene glycol; and group C included prepackaged low-residue diets plus 1.5 L of polyethylene glycol. MAIN OUTCOME MEASURES: The outcome measures were adherence, bowel-cleansing level, and patient satisfaction. RESULTS: One third of the subjects in group A, but none in the prepackaged low-residue diets groups, violated the dietary restrictions. The proportion of right-segment preparation failure was 15.0%, 1.7%, and 6.7% (p = 0.025). Accordingly, treatment B was superior to A (p = 0.008). Among subjects violating the low-residue diets guideline, the right-segment preparation failure rate was 25%. According to a multivariate analysis, low-residue diet compliance (adjusted OR = 6.55 (95% CI, 1.83-23.43)) and BMI were predictors of right-sided preparation adequacy, but the volume of polyethylene glycol ingested was not a predictor. Compared with group A, a greater proportion of subjects in groups B and C reported satisfaction. LIMITATIONS: Patients with high BMI and severe constipation were excluded from this study. This study included only an Asian population. CONCLUSIONS: The prepackaged low-residue diet provides excellent adherence, better bowel cleansing, and a better experience than a self-prepared low-residue diet. With good dietary compliance, 1.5 L of polyethylene glycol provides effective preparation.

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