Randomized Clinical Trial : A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy
Álvarez-González, Marco Antonio (Hospital del Mar (Barcelona, Catalunya))
Pantaleón Sánchez, Miguel Ángel ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital del Mar (Barcelona, Catalunya))
Flores-Le Roux, Juana Antonia ![Identificador ORCID](/img/uab/orcid.ico)
(Universitat Autònoma de Barcelona. Departament de Medicina)
Zaffalon, Diana ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital del Mar (Barcelona, Catalunya))
Amorós Martínez, Jaume (Universitat Oberta de Catalunya)
Bessa Caserras, Xavier ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital del Mar (Barcelona, Catalunya))
Seoane, Agustin (Hospital del Mar (Barcelona, Catalunya))
Pedro-Botet, Juan
(Universitat Autònoma de Barcelona. Departament de Medicina)
Fecha: |
2019 |
Resumen: |
Clinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies. Our aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation. This is a randomized, endoscopist-blinded, noninferiority clinical trial. The study was conducted at a tertiary care center. A total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included. Participants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen. Primary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability. Participants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89. 1% vs 95. 7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0. 04). Low-fiber diet participants reported less fluid-intake perception (p = 0. 04) and less hunger (p = 0. 006), with no differences in bloating or nausea. The single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings. A normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. |
Derechos: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. ![Creative Commons](/img/licenses/by-nc-nd.ico) |
Lengua: |
Anglès |
Documento: |
Article ; recerca ; Versió publicada |
Materia: |
Bowel preparation ;
Colonoscopy ;
Colorectal cancer screening |
Publicado en: |
Diseases of the Colon and Rectum, Vol. 62 (march 2019) , p. 491-497, ISSN 1530-0358 |
DOI: 10.1097/DCR.0000000000001305
PMID: 30844973
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