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A Low-Residue Diet May Improve Participation in Colorectal Cancer Screening

Persons who follow a low-residue diet (LRD) prior to colonoscopy experience superior bowel preparation compared with persons who follow a clear-liquid diet (CLD), according to results of a prospective trial presented at ACG  2019.

Nabil Chehade, MD, from the University of California Irvine Medical Center, and colleagues randomly assigned 170 patients who were scheduled for an outpatient colonoscopy to either a CLD or planned LRD for the full day prior to colonoscopy.

Both groups received split-dose polyethylene glycol electrolyte lavage solution, 4 L.

The Boston Bowel Preparation Scale (BBPS) was used to determine the adequacy of bowel preparation, which was defined as a BBPS score of 7 or higher.

The researchers used a 10-point scale to grade hunger and fatigue before and after colonoscopy. Nausea, vomiting, bloating, abdominal cramping, overall discomfort, satisfaction with the diet, willingness to repeat the same preparation, and overall experience were assessed.

The mean BBPS score was 7.98 and 7.54 among the LRD and CLD groups, respectively.

A greater number of adequate preparations were observed among the patients in the LRD group compared with patients in the CLD group.

Evening hunger scores prior to the initiation of bowel preparation were lower among the patients in the LRD group compared with patients in the CLD group (5.5 vs 7.03, respectively).

Patients in the LRD group experienced significantly less nausea and bloating. Satisfaction with the diet was significantly higher among patients in the LRD group than patients in the CLD group (100% vs 33%, respectively). The overall colonoscopy experience and the satisfaction with the preparation were also reported as better among patients in the LRD group.

Symptom scores for vomiting, abdominal cramping, and overall discomfort were similar between the groups.

“This study demonstrated that the use of a LRD before colonoscopy achieves a superior bowel preparation quality compared to CLD,” Dr Chehade concluded. “Low-residue diet also improves patient satisfaction and results in significantly better tolerability of bowel preparation. As a less restrictive dietary regimen, low-residue diet may help improve patient participation in colorectal cancer screening programs.” —Melinda Stevens

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