Impact of diet restriction on bowel preparation for colonoscopy

Abstract

Diet restriction is one of the difficult parts of bowel preparation for colonoscopy, and many patients do not follow instructions properly. Few studies have evaluated the impact of dietary restriction in real clinical setting. The aim of this study was to study the effect of diet control on bowel preparation with detailed investigation of unacceptable food list in order to reveal what kind of foods are most problematic in clinical practice.Prospective observational study was carried out at a university-affiliated hospital. Around 4 L polyethylene glycol solution was used for bowel preparation on the day of colonoscopy. Patients were allowed to have regular diet until lunch the day before colonoscopy and educated to control diet from 3 days before colonoscopy with information regarding an unacceptable foods list. Factors associated with inadequate bowel preparation were analyzed using univariate statistics and multivariate logistic regression analysis.Of the 245 patients included in the study, 68 patients (27.8%) followed the diet instructions. Fiber-rich vegetables were the most commonly taken unacceptable foods (N = 143, 58.4%). Inadequate bowel preparation (fair and poor by Aronchick scale) was 47.3%. In multivariate analysis, diabetes [odds ratio (OR) 2.878, 95% confidence interval (CI) 1.242–6.671], preparation to colonoscopy interval (OR 1.003, 95% CI 1.000–1.005) and consumption of foods disturbing bowel preparation (OR 2.142, 95% CI 1.108–4.140) were independent predictors of inadequate bowel preparation.We could identify substantially low compliance to diet instructions in real clinical practice. Consumption of any foods disturbing bowel preparation was significant factor predicting inadequate bowel preparation, even though we could not select specific food list compromising preparation significantly. Favorable bowel preparation was achieved in the subgroup compliant to diet restriction, suggesting that regular diet avoiding specific kinds of foods can be possible option for diet restriction before colonoscopy.

Risk factors of poor bowel preparation before colonoscopy: a retrospective cohort study

“…Diet restriction is also known to be a risk factor for bowel preparation [22]. Many studies had shown that clear liquid diet (fruit juices, sports drinks, etc.…”

Efectividad y tolerabilidad de tres tipos de productos de preparación para colonoscopia

“…Las restricciones de la dieta hacen parte de la preparación del colon; y es frecuente que muchos pacientes no sigan estas recomendaciones adecuadamente (35) . En contraste, los pacientes del estudio aceptaron seguir la dieta recomendada baja en residuos (36) , en el 99 % de los casos.…”

Randomized trial of oral sulfate solution versus polyethylene glycol–ascorbic acid for bowel cleansing in elderly people

“…Failure to complete a bowel preparation regimen is an important factor that affects the adequacy of bowel preparation. [1][2][3][4] Owing to the large volume and unpleasant taste of the conventional 4 L of polyethylene glycol electrolyte (PEG) lavage solution, low-volume purgatives with improved flavor and comparable efficacy and safety have been developed. [5][6][7][8][9][10] However, participants in clinical trials using low-volume agents were mainly healthy, young, or middle-aged.…”