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Randomized Controlled Trial
. 2021 Mar;44(3):183-190.
doi: 10.1016/j.gastrohep.2020.06.016. Epub 2020 Sep 15.

Increasing the low residue diet to 3 days does not improve the bowel cleansing in hard to prepare patients: Post hoc analysis of a randomized controlled trial

[Article in English, Spanish]
Antonio Z Gimeno-García  1 , Raquel de la Barreda-Heuser  2 , Cristina Reygosa  2 , Alberto Hernández  2 , Carla Amaral  2 , Isabel Mascareño  3 , David Nicolás-Pérez  2 , Alejandro Jiménez  2 , Antonio J Lara  2 , Anjara Hernández  2 , Vanessa Felipe  2 , José Luis Baute  2 , Onofre Alarcon-Fernández  2 , Manuel Hernandez-Guerra  2 , Rafael Romero  2 , Inmaculada Alonso  2 , Yanira González  2 , Zaida Adrian  2 , Goretti Hernandez  2 , Domingo Hernandez  2 , Rosa Delgado  2 , Enrique Quintero  2
Affiliations
Randomized Controlled Trial

Increasing the low residue diet to 3 days does not improve the bowel cleansing in hard to prepare patients: Post hoc analysis of a randomized controlled trial

[Article in English, Spanish]
Antonio Z Gimeno-García et al. Gastroenterol Hepatol. 2021 Mar.

Abstract

Background: Recent evidence suggests that the number of low residue diet (LRD) days does not influence the bowel cleansing quality in non-selected patients. However, there are not data in the subgroup of patients with risk factors of inadequate bowel cleansing.

Objective: The aim of this study was to assess whether a 3-day LRD improved the bowel cleansing quality in patients with risk factors of poor bowel cleansing.

Patients and methods: Post hoc analysis of a randomized controlled trial carried out between December 2017 and March 2018 in a tertiary care hospital. Patients with high risk of poor bowel cleansing were selected following a validated score. The patients 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. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the main outcome.

Results: 135 patients (1-day LRD group=67, 3-day LRD=68) were included. The rate of adequate cleansing quality was not significantly different between the groups in the ITT analysis: 76.1%, 95% CI: [64.6-84.8] vs. 79.4%, 95% CI: [68.2-87.4]; odds ratio (OR) 1.2, 95% CI [0.54-2.73]) or in the PP analysis: 77.3%, 95% CI: [65.7-85.8] vs. 80.3%, 95% CI: [69.0-88.3]; OR 1.2, 95% CI [0.52-2.77]). Compliance with the diet or cleansing solution, satisfaction or difficulties with the LRD and the polyp/adenoma detection rates were not significantly different.

Conclusion: Our results suggest that 1-day LRD is not inferior to 3-day LRD in patients with risk factors of inadequate bowel cleansing.

Keywords: Boston Bowel Preparation Scale; Colonoscopia; Colonoscopy; Dieta baja en residuos; Escala de preparación intestinal de Boston; Factores de riesgo de limpieza intestinal deficiente; Low-residue diet; Predictive score; Puntuación predictiva; Risk factors of poor bowel cleansing.

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