Effect of Diet Liberalization on Bowel Preparation

Danny J. Avalos, Daniel A Sussman, Luis F. Lara, Fayez S. Sarkis, Fernando J. Castro

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: Precolonoscopy dietary regimens often are restricted to clear liquids; however, the superiority of a clear liquid diet (CLD) for bowel preparation quality is ambiguous. We performed a meta-analysis of randomized trials comparing bowel preparation outcomes between a low-residue diet (LRD) or regular diet (RD) compared with a CLD. Methods: MEDLINE, clinicaltrials.gov, Cochrane Central Register, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Web of Science databases were used to conduct a search for randomized controlled trials from 1976 to March 2015. Of 122 relevant references, 12 studies met our inclusion criteria, 7 studies of which were classified as being of high quality. Pooled estimates of bowel preparation quality were defined as adequate versus inadequate. Secondary outcomes included tolerability, willingness to repeat bowel preparation, adverse events, and adenoma detection rate. Pooled estimates of relative risk (RR) were used for dichotomous variables and standardized mean difference for continuous variables. Results: In the high-quality studies, there were no differences in bowel preparation quality among the LRD/RD and CLD groups (RR 0.98; 95% confidence interval [CI] 0.93-1.04). Analysis of secondary outcomes included all of the studies. Tolerability (RR 1.04, 95% CI 1.01-1.08) and willingness to repeat favored the liberalized diet arm (RR 1.08, 95% CI 1.01-1.16). There was no significant difference in the adenoma detection rate, whereas hunger was more common in the CLD group. Conclusions: An LRD/RD provided no difference in bowel preparation quality as compared with a CLD. As such, it may be reasonable for patients without risk factors for poor preparation to undergo an LRD until lunch the day before their colonoscopy given that bowel preparation tolerability and willingness to repeat were greater among groups with a liberalized diet.

Original languageEnglish (US)
Pages (from-to)399-407
Number of pages9
JournalSouthern Medical Journal
Volume110
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

Diet
Confidence Intervals
Adenoma
Lunch
Hunger
Colonoscopy
MEDLINE
Meta-Analysis
Nursing
Randomized Controlled Trials
Databases
Health

Keywords

  • bowel preparation quality
  • clear liquid diet
  • colonoscopy
  • low-residue diet
  • regular diet

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of Diet Liberalization on Bowel Preparation. / Avalos, Danny J.; Sussman, Daniel A; Lara, Luis F.; Sarkis, Fayez S.; Castro, Fernando J.

In: Southern Medical Journal, Vol. 110, No. 6, 01.06.2017, p. 399-407.

Research output: Contribution to journalArticle

Avalos, DJ, Sussman, DA, Lara, LF, Sarkis, FS & Castro, FJ 2017, 'Effect of Diet Liberalization on Bowel Preparation', Southern Medical Journal, vol. 110, no. 6, pp. 399-407. https://doi.org/10.14423/SMJ.0000000000000662
Avalos, Danny J. ; Sussman, Daniel A ; Lara, Luis F. ; Sarkis, Fayez S. ; Castro, Fernando J. / Effect of Diet Liberalization on Bowel Preparation. In: Southern Medical Journal. 2017 ; Vol. 110, No. 6. pp. 399-407.
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