UC Irvine Health study finds less restrictive diet may be superior to clear liquids prior to colonoscopy

Patient satisfaction may help increase colon cancer screening participation

May 23, 2016

A UC Irvine Health study found that patients on a low residue diet before colonoscopy achieved a bowel preparation quality that may be superior to patients restricted to a clear liquid diet. The less restrictive diet also improved patient satisfaction, which may help increase colonoscopy participation.

UC Irvine Health gastroenterologist Dr. Jason Samarasena presented the findings at the 2016 Digestive Diseases Week meeting in San Diego on May 23.

“Colon cancer deaths can be prevented by colonoscopy, yet colorectal screening participation remains low,” Samarasena said. “For many people, the idea of taking strong laxatives and not being able to eat anything for eight to 12 hours is unpleasant, and so they decide to not have a colonoscopy. They think that if they don’t have any symptoms, there’s no need to have the procedure. The problem is that most often, people don’t have symptoms of colon cancer until the disease is very advanced.”

Colonoscopy patients must have nothing in their bowels so the physician can clearly see the interior walls and check for abnormalities. The adequacy of bowel preparation was evaluated according to the Boston Bowel Preparation Scale. Hunger and fatigue pre- and post-procedure were graded on a 10-point scale.

Study participants using the conventional clear liquid diet were allowed to consume drinks such as broth, black coffee and tea the day before colonoscopy. In contrast, those following the low residue diet were allowed to eat three meals that included small portions of foods such as eggs, yogurt, bread, rice, chicken breast, and ice cream.

“These foods are easily liquefied in the small intestine and can be washed out easily, so they don't interfere with the colonoscopy procedure,” Samarasena said.

There were a significantly higher number of adequate preparations in the low residue diet patients, as well as a higher mean BBPS. Low residue diet patients also reported significantly lower scores for evening hunger just prior to purgative intake and morning post-prep fatigue. Their scores for diet satisfaction were significantly higher than those of patients who consumed a traditional clear liquid diet.

“Bowel preparation and dietary restrictions are the most-often cited deterrents to undergoing colonoscopy,” Samarasena said. “This study shows that a low residue diet results in a high quality bowel preparation score, and significantly better patient tolerability, which may help increase participation in colorectal screening.”

The multicenter, randomized, single blinded, prospective trial involved 83 patients who underwent a colonoscopy from November 2014 to November 2015.

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