S590 1-Day vs 3-Day Low Residue Diet for Colonoscopy Bowel Cleansing: A Systematic Review

Abstract Background The aim of this study was to assess whether a 3-day low-residue diet (LRD) improved bowel cleansing quality compared with a 1-day LRD regimen. Methods Consecutive patients scheduled for outpatient colonoscopy were randomized to the 1-day LRD or 3-day LRD groups. All patients received a 2-L split-dose of polyethylene glycol plus ascorbic acid. The primary outcome was bowel cleansing quality as evaluated using the Boston Bowel Preparation Scale (BBPS) (adequate cleansing ≥ 2 points per segment). Secondary outcomes were adherence to and level of satisfaction with the LRD, difficulty following the dietary recommendations, and willingness to repeat the same LRD in the future. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome. A superiority analysis was performed to demonstrate that a 3-day LRD regimen was superior to a 1-day LRD regimen with a margin of 10 %. Results 390 patients (1-day LRD group = 196, 3-day LRD = 194) were included. The cleansing quality was not significantly different between the groups: ITT analysis 82.7 % (95 % confidence interval [CI] 77.4 to 88.0) vs. 85.6 % (95 %CI 80.7 to 90.5), with odds ratio (OR) 1.2 (95 %CI 0.72 to 2.15); PP analysis 85.0 % (95 %CI 79.9 to 90.1) vs. 88.6 % (95 %CI 84.0 to 93.2), with OR 1.4 (95 %CI 0.88 to 2.52). No differences were found regarding adherence to the diet or cleansing solution, satisfaction or difficulty with the LRD, and the polyp/adenoma detection rates. Conclusion 3-day LRD did not offer advantages over 1-day LRD in preparation for colonoscopy.

Download Full-text

EFFECT OF A LOW RESIDUE DIET DURING ONE DAY VERSUS THREE DAYS ON BOWEL CLEANSING, DIET TOLERANCE AND COLONOSCOPY PERFORMANCE: A NON-INFERIORITY RANDOMISED CLINICAL TRIAL

10.1055/s-0040-1704210 ◽

2020 ◽

Author(s):

S Machlab ◽

E Martínez-Bauer ◽

P López ◽

A Lira ◽

V Puig-Diví ◽

...

Keyword(s):

Clinical Trial ◽

Randomised Clinical Trial ◽

Bowel Cleansing ◽

Low Residue Diet

Download Full-text

Use of smartphone applications to improve quality of bowel preparation for colonoscopy: a systematic review and meta-analysis

Endoscopy International Open ◽

10.1055/a-0796-6423 ◽

2019 ◽

Vol 07 (02) ◽

pp. E216-E224 ◽

Cited By ~ 7

Author(s):

Madhav Desai ◽

Venkat Nutalapati ◽

Ajay Bansal ◽

Daniel Buckles ◽

John Bonino ◽

...

Keyword(s):

Systematic Review ◽

Bowel Preparation ◽

Meta Analysis ◽

Smartphone App ◽

Control Group ◽

Smartphone Apps ◽

Standard Education ◽

Bowel Cleansing ◽

Bowel Prep

Abstract Introduction Smartphone-based applications (apps) have been used to improve the quality of bowel preparation (prep) but the success rates have been variable. We have performed a systematic review and meta-analysis to evaluate the impact of smartphone apps on bowel preparation. Methods Electronic databases (MEDLINE, Embase, CINAHL and Cochrane) were reviewed for eligible studies of smartphone apps versus standard education before colonoscopy. The following outcomes were analyzed: pooled rate of adequacy of bowel prep among both arms and Boston bowel preparation score (BBPS) when reported. Pooled analysis was reported as odds ratio (OR) or mean difference in random effect model with Review Manager 5.3 (P ≤ 0.05 for statistical significance). Results Six studies were eligible with smartphone app (810 patients) vs. standard education (855 patients, control group) for bowel prep. The smartphone app group had a higher proportion of adequate bowel prep compared to the control group: 87.5 % vs 77.5 % (five studies), pooled OR 2.67; 95 %CI 1.00 – 7.13 with P = 0.05. There was substantial heterogeneity in studies with I 2 = 78 %. When analysis was limited to randomized controlled trials (RCTs), smartphone app users had a numerically higher rate of bowel cleansing: 87.1 % vs 76.9 %; however, pooled OR was not statistically significant (OR 2.66, 95 %CI 0.92 – 7.69, P = 0.07). When studies using BBPS were evaluated (n = 3), smartphone app users had higher mean scores (better bowel prep) with a mean difference of 0.9 (95 %CI 0.5 – 1.3), which was statistically significant (P < 0.01). Conclusion The smartphone app is a novel educational tool that can assist in achieving adequate and better bowel cleansing before colonoscopy.

Download Full-text

Efficacy and tolerability of a low-residue diet for bowel preparation: systematic review and meta-analysis

Surgical Endoscopy ◽

10.1007/s00464-021-08703-8 ◽

2021 ◽

Author(s):

Cristian Ahumada ◽

Lisandro Pereyra ◽

Martín Galvarini ◽

José Mella ◽

Estanislao Gómez ◽

...

Keyword(s):

Systematic Review ◽

Bowel Preparation ◽

Meta Analysis ◽

Low Residue Diet

Download Full-text

A2 THE BOWEL CLEANSING NATIONAL INITIATIVE (BCLEAN): PREDICTORS OF INADEQUATE BOWEL PREPARATION

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.001 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 2-3

Author(s):

A N Barkun ◽

M Martel ◽

I L Epstein ◽

P Hallé ◽

R J Hilsden ◽

...

Keyword(s):

Randomized Trial ◽

Bowel Preparation ◽

High Volume ◽

Random Allocation ◽

Charlson Score ◽

Split Dose ◽

Bowel Cleansing ◽

Low Residue Diet ◽

Low Volume ◽

Inadequate Bowel Preparation

Abstract Background Adequate bowel cleansing before colonoscopy is, in theory, a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta- analyses. The complexity resides in all the pre-endoscopic factors surrounding preparation intake that may? influence quality of the bowel preparation. Aims To identify preendoscopic variables associated with inadequate bowel preparation Methods In this randomized trial conducted in adult outpatients in 10 Canadian hospitals, all early morning (AM) colonoscopies were scheduled between 7h30AM and 10h30AM and patients were randomized to PEG low volume or high- volume split-dose or high- volume day before. Later colonoscopies (PM) were scheduled between 10h30AM and 16h30PM and patients were randomized to PEG low-volume or high- volume split-dose or low- volume same day. A secondary random allocation assigned patients to a clear fluid or low residue diet. Inadequate bowel preparation was identified on the Boston Bowel Preparation Scale with a total score <6 with any of the 3 colonic segments subscores <2). All preendoscopic variables such as patients related factors, diet and type of bowel preparation were evaluated between groups with chi-square, Fisher’s exact or t-test where appropriate. All variables found to be significantly associated with a clean preparation on univariable analysis at the P=0.15 level were used to construct a multivariable model. Because of stratified randomization by time with possible resulting differing confounders, AM and PM patients were analysed separately. Results Over 29 months, 1726 patients were stratified in the AM group and 1750 patients in the PM group. 16.9% had inadequate bowel preparation in the AM group and 9.8% in the PM group. Pre-endoscopic variables associated with an inadequate bowel cleanliness in AM colonoscopy were a non screening indication (OR 1.36, 95%CI 1.04–1.78), a Charlson score>0 (OR 1.36, 95% 1.03–1.80) and a low residue diet (OR 1.53, 95%CI 1.17–2.01). Amongst PM colonoscopies, variables associated with an inadequate bowel cleanliness were increased age (OR 1.03, 95% 1.01–1.04), a non screening indication (OR 1.90 95%CI 1.35–2.70); a Charlson score>0 (OR 1.63, 95%CI 1.15–2.32), and a low residue diet (OR 1.41, 95%CI 1.01; 1.98). Conclusions In this large randomized trial, amongst patients undergoing an AM colonoscopy, pre- endoscopic factors associated with an inadequate bowel preparation were a non screening indication, comorbidities and a low residue diet. Amongst PM colonoscopy patients, in addition to these variables, an increased age was also associated with an inadequate bowel preparation. Funding Agencies received arm-length funding from Pendopharm Inc.

Download Full-text

S0531 What Is the Ideal Dietary Regimen for Patients Scheduled for Colonoscopy: Low Residue Diet or Clear Liquid Diet? A Meta-Analysis and Systematic Review of Randomized Controlled Trials

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000704172.47138.5f ◽

2020 ◽

Vol 115 (1) ◽

pp. S259-S259

Author(s):

Nabil El Hage Chehade ◽

Alexander Abadir ◽

Zain Moosvi ◽

Sagar Shah ◽

Jason Samarasena

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Clear Liquid ◽

Dietary Regimen ◽

Clear Liquid Diet ◽

Randomized Controlled ◽

Low Residue Diet ◽

The Ideal

Download Full-text

A reduced bowel cleansing regimen for colonoscopy using a pre-packaged low-residue diet

Progress of Digestive Endoscopy ◽

10.11641/pde.83.1_74 ◽

2013 ◽

Vol 83 (1) ◽

pp. 74-76

Author(s):

Naoki Hosoe ◽

Makoto Naganuma ◽

Kazuhiro Kashiwagi ◽

Hiroyuki Imaeda ◽

Takanori Kanai ◽

...

Keyword(s):

Bowel Cleansing ◽

Low Residue Diet

Download Full-text

Explanation and elucidation of cancer in reference to Greco-Arabic literature

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v18i2.40683 ◽

2019 ◽

Vol 18 (2) ◽

pp. 184-189

Author(s):

Wasim Ahmad ◽

Mohd Zulkifle ◽

Hamiduddin ◽

Sadaf Afreen ◽

Obaidur Rahman

Keyword(s):

Systematic Review ◽

Developing Countries ◽

Differential Diagnosis ◽

Medical Science ◽

The Body ◽

Arabic Literature ◽

Surgical Interventions ◽

Ibn Sina ◽

Bowel Cleansing ◽

Muslim Scholars

Muslim scholars made tremendous contribution in various fields of science and their benefaction of work exhibits in all branches of medicine. Cancer is discussed by then Muslim scholars like Ibn Sina, Razi , Ismail Jurjani ,Hunain b. Ishaque, Rabban Tabri, Ahmad b. Mohammad Tabri, , Ibn ul Quff, Ibn Zuhr etc. In their descriptions cancer means Sartan (crab) as it reflects the true character of disease, since it sticks to the part stubbornly like a Sartan. Galen states that Sartan is the result of an excess of black bile. It may be due to an excessive hotness and dryness of liver by which consumed foods transform into irritant morbid matter. Concurrently, the spleen becomes weak and is unable to absorb the Sawda (black bile). Muslim scholars classified and distinguished clearly among the varieties of cancer in relation to specific organs such as eye, stomach, bladder, penis, uterus, mouth, and nerve tumours. The need of the hour is to evaluate and analyse the disease along with its pathophysiology, predisposing factors, differential diagnosis, and varieties of therapeutic paradigms that include nutrition, drugs, Ishal (bowel cleansing), Tanqia (evacuation of morbid matter from the body), surgical and non surgical interventions i.e. leaching , Amal kai (cauterization). Since the cancer is spreading at an incredible rate in both developed and developing countries but no way of relief is ensured yet in any system of medicine. Greco-Arabic literature has rich potential to intervene in palliative way in such dreadful disease. Likewise, Ray born Razi asserted that when cancer is at the beginning, it can be kept stationary and can be prevented from ulceration. This systematic review highlights relevant Greco-Arabic literature on cancer. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.184-189

Download Full-text