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

Abstract

SUMMARYBackground: A colon free of faecal residue is required for accurate diagnostic colonoscopy. Patient tolerance of his/her colonoscopy cathartic regimen affects patient compliance and willingness to undergo repeated examinations. Aim: To determine whether a meal could be consumed during standard bowel preparation. Methods: This was a randomized, endoscopists' blinded comparison of the tolerability and efficacy of a prepackaged, low-residue diet (NutraPrep) combined with the LoSo Prep bowel cleansing system, which contains magnesium citrate, bisocodyl tablets and a bisocodyl

Split dose and MiraLAX-based purgatives to enhance bowel preparation quality becoming common recommendations in the US

“…Clear liquid-only diet is recommended in review articles on this subject and in the consensus statement on bowel preparation prior to colonoscopy offered by the task force including the American Society of Gastrointestinal Endoscopy and the American Society of Colon and Rectal Surgeons [A-Rahim and Falchuk, 2011;Wexner et al 2006]. Studies of precolonoscopy diet, however, show that the efficacy of cleansing is comparable for clear liquid diet and other diets that include any food, whether low residue [Delegge and Kaplan, 2005;Rapier and Houston, 2006;Wu et al 2011], fiber-free [Soweid et al 2010], or regular [Aoun et al 2005;Scott et al 2005]. Of the physicians in this study that do recommend a liberal diet, respondents in the Northeastern US were twice as likely as physicians in the South and more than three times as likely as physicians in the West, including Hawaii, to use this approach.…”

“…While data regarding the impact of diet on the quality of experience from the patient's perspective are sparse, bowel preparation remains the most unpleasant aspect of colonoscopy [Ko et al 2007] and a diet that is more lenient than that of clear liquids only is rated more favorably [Delegge and Kaplan, 2005]. In the context of a procedure that is performed on more than 14 million individuals annually in the United States [Seeff et al 2004], seemingly minor changes in dietary recommendations may have a substantial public health impact on purgative compliance.…”

“…Split dosing of the purgative, that is, the administration of a portion of the purgative on the day of colonoscopy, has been consistently shown to improve bowel preparation quality [Abdul-Baki et al 2008;Kilgore et al 2011;Marmo et al 2010;Park et al 2007Park et al , 2010. With regard to precolonoscopy diet, several studies have examined the impact of alternative dietary recommendations (low-residue [Delegge and Kaplan, 2005;Rapier and Houston, 2006;Wu et al 2011] or fiber-free diet [Soweid et al 2010], light breakfast followed by clear liquids [Scott et al 2005], and regular diet followed by clear liquids or low-residue meals [Aoun et al 2005]) with a variety of purgative agents and found that bowel cleansing and patient tolerability were at least as good as with a clear liquid diet, if not better. The relative use of some of these newer methods among US physicians in clinical practice is unknown.…”

Preparing for Colonoscopy

“…Magnesium citrate in combination with 2 liter PEG-ELS solution has also been shown to improve preparation quality and improve patient satisfaction compared to 4 liter PEG-ELSs (Sharma et al, 1998). Combination preparations containing magnesium citrate also include a 240-mL dose of balanced magnesium solution and 20 mg bisacodyl(oral) the evening before the procedure and a 10-mg bisacodyl suppository the morning of the procedure ( Delegge and Kaplan, 2005).A pulsed rectal irrigation with magnesium citrate as also been suggested to enhance preparation for colonoscopy; however, this requires skilled nursing for administration and is associated with a high cost (Chang et al, 1991).…”

Comparison of colon-cleansing methods in preparation for colonoscopy - Comparative efficacy of solutions of mannitol, sodium picosulfate and monobasic and dibasic sodium phosphates

“…Nevertheless, to ensure success of the procedure, it is necessary an efficient bowel preparation: a high-quality colon-cleansing, associated with safe, efficient and of good tolerance solutions and minimal side effects would be ideal. 1,2 Two methods for colon cleansing are available: the anterograde, which uses the natural bowel outflow, and the retrograde, by means of colonic lavage. In recent years, most authors have been using anterograde methods for bowel preparation due to its good quality cleansing and also to the patients' tolerance and acceptance.…”