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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
Authors:Antonio Z. Gimeno-García  Raquel de la Barreda-Heuser  Cristina Reygosa  Alberto Hernández  Carla Amaral  Isabel Mascareño  David Nicolás-Pérez  Alejandro Jiménez  Antonio J. Lara  Anjara Hernández  Vanessa Felipe  José Luis Baute  Onofre Alarcon-Fernández  Manuel Hernandez-Guerra  Rafael Romero  Inmaculada Alonso  Yanira González  Zaida Adrian  Enrique Quintero
Affiliation:1. Servicio de Gastroenterología, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Departamento de Medicina Interna, Universidad de La Laguna, Spain;2. Servicio de Endocrinología y Nutrición, Hospital San Juan de Dios, Santa Cruz de Tenerife, Spain
Abstract:
BackgroundRecent 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.ObjectiveThe 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 methodsPost 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.Results135 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.ConclusionOur results suggest that 1-day LRD is not inferior to 3-day LRD in patients with risk factors of inadequate bowel cleansing.
Keywords:Low-residue diet  Risk factors of poor bowel cleansing  Boston Bowel Preparation Scale  Colonoscopy  Predictive score  Dieta baja en residuos  Factores de riesgo de limpieza intestinal deficiente  Escala de preparación intestinal de Boston  Colonoscopia  Puntuación predictiva
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