Gut and Liver

The Korean Association for the Study of the Liver (대한간학회)
권호 표지
DOI QR코드

DOI QR Code

A Clear Liquid Diet Is Not Mandatory for Polyethylene Glycol-Based Bowel Preparation for Afternoon Colonoscopy in Healthy Outpatients

  • Jung, Yoon Suk (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Seok, Hyo Sun (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Dong Il (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Song, Chang Seok (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Seong Eun (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Lee, Suck Ho (Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Eun, Chang Soo (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Han, Dong Soo (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Kim, Yong Soo (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Lee, Chang Kyun (Department of Internal Medicine, Kyung Hee University School of Medicine)
  • Received : 2013.01.24
  • Accepted : 2013.02.23
  • Published : 2013.11.15
⟨ Previous Next ⟩

Abstract

Background/Aims: A dietary regimen consisting of a clear liquid diet (CLD) for at least 24 hours is recommended for colonoscopy preparation. However, this requirement results in problems in patient compliance with bowel preparation. The aim of this study was to evaluate the efficacy of a CLD compared with a regular diet (RD) for colonoscopy preparation using a polyethylene glycol (PEG) solution. Methods: This was a multicenter, randomized, investigator-blind prospective study. A total of 801 healthy outpatients undergoing afternoon colonoscopy were randomized to either a CLD or RD in addition to a 4 L PEG regimen. Results: The quality of bowel cleansing was not different between the CLD and RD groups in terms of the proportion with excellent or good preparation. In addition, no significant differences were observed between the two groups for polyp and adenoma detection rates and overall adverse events. Good compliance with bowel preparation was higher in the RD group than in the CLD group. Conclusions: A CLD for a full day prior to colonoscopy should not be mandatory for PEG-based bowel preparation. Dietary education concerning the avoidance of high-fiber foods for 3 days before colonoscopy is sufficient, at least for healthy outpatients.

Keywords

References

  1. Labianca R, Merelli B. Screening and diagnosis for colorectal cancer: present and future. Tumori 2010;96:889-901.
  2. Haseman JH, Lemmel GT, Rahmani EY, Rex DK. Failure of colonoscopy to detect colorectal cancer: evaluation of 47 cases in 20 hospitals. Gastrointest Endosc 1997;45:451-455. https://doi.org/10.1016/S0016-5107(97)70172-X
  3. Gorski TF, Rosen L, Riether R, Stasik J, Khubchandani I. Colorectal cancer after surveillance colonoscopy: false-negative examination or fast growth? Dis Colon Rectum 1999;42:877-880. https://doi.org/10.1007/BF02237093
  4. Faiss S. The missed colorectal cancer problem. Dig Dis 2011;29 Suppl 1:60-63. https://doi.org/10.1159/000331119
  5. Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc 2003;58:76-79. https://doi.org/10.1067/mge.2003.294
  6. Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc 2005;61:378-384. https://doi.org/10.1016/S0016-5107(04)02776-2
  7. Rex DK, Petrini JL, Baron TH, et al. Quality indicators for colonoscopy. Gastrointest Endosc 2006;63(4 Suppl):S16-S28. https://doi.org/10.1016/j.gie.2006.02.021
  8. Davis GR, Santa Ana CA, Morawski SG, Fordtran JS. Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology 1980;78(5 Pt 1):991-995.
  9. El Sayed AM, Kanafani ZA, Mourad FH, et al. A randomized single-blind trial of whole versus split-dose polyethylene glycolelectrolyte solution for colonoscopy preparation. Gastrointest Endosc 2003;58:36-40. https://doi.org/10.1067/mge.2003.318
  10. Aoun E, Abdul-Baki H, Azar C, et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc 2005;62:213-218. https://doi.org/10.1016/S0016-5107(05)00371-8
  11. Delegge M, Kaplan R. Efficacy of bowel preparation with the use of a prepackaged, low fibre diet with a low sodium, magnesium citrate cathartic vs. a clear liquid diet with a standard sodium phosphate cathartic. Aliment Pharmacol Ther 2005;21:1491-1495. https://doi.org/10.1111/j.1365-2036.2005.02494.x
  12. Rapier R, Houston C. A prospective study to assess the efficacy and patient tolerance of three bowel preparations for colonoscopy. Gastroenterol Nurs 2006;29:305-308. https://doi.org/10.1097/00001610-200607000-00007
  13. Church JM. Effectiveness of polyethylene glycol antegrade gut lavage bowel preparation for colonoscopy: timing is the key! Dis Colon Rectum 1998;41:1223-1225. https://doi.org/10.1007/BF02258217
  14. Park JS, Sohn CI, Hwang SJ, et al. Quality and effect of single dose versus split dose of polyethylene glycol bowel preparation for early-morning colonoscopy. Endoscopy 2007;39:616-619. https://doi.org/10.1055/s-2007-966434
  15. Hookey LC, Depew WT, Vanner SJ. A prospective randomized trial comparing low-dose oral sodium phosphate plus stimulant laxatives with large volume polyethylene glycol solution for colon cleansing. Am J Gastroenterol 2004;99:2217-2222. https://doi.org/10.1111/j.1572-0241.2004.40482.x
  16. Hwang KL, Chen WT, Hsiao KH, et al. Prospective randomized comparison of oral sodium phosphate and polyethylene glycol lavage for colonoscopy preparation. World J Gastroenterol 2005;11:7486-7493.
  17. Katsinelos P, Pilpilidis I, Paroutoglou G, et al. The administration of cisapride as an adjuvant to PEG-electrolyte solution for colonic cleansing: a double-blind randomized study. Hepatogastroenterology 2005;52:441-443.
  18. DiPalma JA, Wolff BG, Meagher A, Cleveland M. Comparison of reduced volume versus four liters sulfate-free electrolyte lavage solutions for colonoscopy colon cleansing. Am J Gastroenterol 2003;98:2187-2191. https://doi.org/10.1111/j.1572-0241.2003.07690.x
  19. Sharma VK, Chockalingham SK, Ugheoke EA, et al. Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation. Gastrointest Endosc 1998;47:167-171. https://doi.org/10.1016/S0016-5107(98)70351-7
  20. Park DI, Park SH, Lee SK, et al. Efficacy of prepackaged, low residual test meals with 4L polyethylene glycol versus a clear liquid diet with 4L polyethylene glycol bowel preparation: a randomized trial. J Gastroenterol Hepatol 2009;24:988-991. https://doi.org/10.1111/j.1440-1746.2009.05860.x
  21. Scott SR, Raymond PL, Thompson WO, Galt DJ. Efficacy and tolerance of sodium phosphates oral solution after diet liberalization. Gastroenterol Nurs 2005;28:133-139. https://doi.org/10.1097/00001610-200503000-00008
  22. Soweid AM, Kobeissy AA, Jamali FR, et al. A randomized singleblind trial of standard diet versus fiber-free diet with polyethylene glycol electrolyte solution for colonoscopy preparation. Endoscopy 2010;42:633-638. https://doi.org/10.1055/s-0029-1244236
  23. Jayanthi V, Ramathilakam B, Malathi S, Dinakaran N, Balasubramanian V. Comparison of polyethylene glycol versus combination of magnesium sulphate and bisacodyl for colon preparation. Trop Gastroenterol 2000;21:18-19.
  24. Yoon JH, Park DI, Shin JE, et al. Comparison of bowel preparation depending on completion time of polyethylene glycol ingestion and start time of colonoscopy Intest Res 2010;8:24-29. https://doi.org/10.5217/ir.2010.8.1.24
  25. Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol 2001;96:1797-1802. https://doi.org/10.1111/j.1572-0241.2001.03874.x
  26. Kim HS, Park DH, Kim JW, et al. Effectiveness of walking exercise as a bowel preparation for colonoscopy: a randomized controlled trial. Am J Gastroenterol 2005;100:1964-1969. https://doi.org/10.1111/j.1572-0241.2005.40373.x

Cited by

  1. Sodium Picosulfate with Magnesium Citrate (SPMC) Plus Laxative Is a Good Alternative to Conventional Large Volume Polyethylene Glycol in Bowel Preparation: A Multicenter Randomized Single-Blinded Tria vol.9, pp.4, 2015, https://doi.org/10.5009/gnl14010
  2. The White Diet is preferred, better tolerated, and non‐inferior to a clear‐fluid diet for bowel preparation: A randomized controlled trial vol.31, pp.2, 2013, https://doi.org/10.1111/jgh.13078
  3. Effect of Diet Liberalization on Bowel Preparation vol.110, pp.6, 2013, https://doi.org/10.14423/smj.0000000000000662
  4. Same-Day Single Dose of 2 Liter Polyethylene Glycol is Not Inferior to The Standard Bowel Preparation Regimen in Low-Risk Patients: A Randomized, Controlled Trial vol.113, pp.4, 2013, https://doi.org/10.1038/ajg.2018.25