Dataset Information

Effect of single-day versus multi-day low-residue diet on colonoscopy bowel preparation: a systematic review and meta -analysis.

ABSTRACT:

Introduction

To compare the effects of single-day and multi-day low-residue diets on bowel preparation quality and patient tolerance of colonoscopy.

Methods

A systematic review and meta-analysis of randomized controlled trials were conducted to compare the efficacy of a single-day low-residue diet and a multi-day low-residue diet for bowel preparation for colonoscopy. Relevant articles were screened from PubMed, Web of Science, Cochrane Library, and Embase databases from inception till December 10, 2024. Data were extracted and analyzed using Review Manager software after data extraction.

Results

In total, 2248 patients from five randomized controlled trials were included in the meta-analysis. In the intention-to-treat population, the adequate bowel preparation rates were 90.1% and 89.7% in the single-day and multi-day low-residue diet groups, respectively (pooled odds ratio [OR] = 1.03, 95% confidence interval [CI]: 0.76-1.41, p = 0.84). In the per-protocol population, the adequate bowel preparation rates were 91.3% and 90.2% in the single-day and multi-day low-residue diet groups, respectively (pooled OR = 1.14, 95% CI: 0.84-1.54, p = 0.40). Four studies examined patient tolerance (pooled OR = 1.87, 95% CI: 1.52-2.31, p < 0.01), whereas three examined the patients' willingness to repeat the same dietary restrictions (pooled OR = 2.91, 95% CI: 1.61-5.25, p < 0.01).

Conclusions

There is no significant difference in the quality of bowel preparation between single-day and multi-day low-residue diets before colonoscopy. However, patient tolerance and willingness to repeat the same dietary restrictions were higher in the single-day low-residue diet than in the multi-day low-residue diet.

SUBMITTER: Du J

PROVIDER: S-EPMC12465615 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature

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Publications

Effect of single-day versus multi-day low-residue diet on colonoscopy bowel preparation: a systematic review and meta -analysis.

Du Jing J He Xueqian X Li Peng P

BMC gastroenterology 20250926 1

<h4>Introduction</h4>To compare the effects of single-day and multi-day low-residue diets on bowel preparation quality and patient tolerance of colonoscopy.<h4>Methods</h4>A systematic review and meta-analysis of randomized controlled trials were conducted to compare the efficacy of a single-day low-residue diet and a multi-day low-residue diet for bowel preparation for colonoscopy. Relevant articles were screened from PubMed, Web of Science, Cochrane Library, and Embase databases from inception ...[more]

PMID: 41013317

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Project description:One tricky aspect of the recommendations for colonoscopy prep is diet. This has a significant impact on the experience of the patient or participant in the screening program and, on the other hand, low adherence has been found in some studies despite a potential Hawthorne effect . It is noteworthy that despite its impact on patient experience, it is an area for which little evidence is available, which is why the guidelines give low-quality recommendations and there is probably considerable variability in clinical practice . In the early days of colonoscopy, a liquid diet for 48 hours was mainly recommended, although some centers indicated a low-residue diet or even the commercially available NASA astronaut diet. Later, the indication for a liquid diet was consolidated until finally numerous studies were published in favor of a low-residue diet, managing to increase tolerance and the quality of the preparation . A limitation of the preparation studies must be borne in mind that the colon cleansing rating scales were not introduced until 1999 when the Aronchick scale was published. Although there is solid evidence in favor of a low-residue diet versus a liquid diet, the investigators do not have evidence on how many days of a low-residue diet should be recommended, and this is reflected in the ESGE (European Society of Gastrointestinal Endoscopy) and ASGE (American Society of Gastrointestinal Endoscopy) guidelines . A randomized clinical trial comparing 3 days versus 1 day of a low residue diet has recently been published . There were no statistically significant differences in the rate of adequate preparations (82.7% vs. 85.6% OR 1.2 95% IC 0.72 to 2.15). However, this study has limited statistical power and a design that allows a non-inferiority analysis has not been followed. In relation to this, our research group is finalizing a non-inferiority clinical trial in whose intermediate analysis, with 421 participants, the non-inferiority of 1 day of diet is fulfilled (rate of poor preparation in 1 day 0.95% vs. 4.74% in 3 days; d + 5%, difference -3.78% IC -6.88% to -1.12%) (38). It is likely, taking into account the available evidence and its evolution, that diet plays a secondary role in preparation. Although no studies designed to directly assess this have been conducted, the research group has indirect data. Walter et al, under the hypothesis that the impact of the fractional preparation and the new preparations on the preparation diminished the importance of the diet, conducted a non-inferiority clinical trial between 2012 and 2013 in which they randomized the patients to follow a diet liquid versus low residue for one day and fractional preparation with Moviprep (39). They established a non-inferiority margin of -13.5%. Their results show a rate of good preparation (Boston> 5) in 68/72 (94.4%) in a liquid diet compared to 60/68 (88.2%) in a low-residue diet (p = 0.04) with a difference of -5.08% demonstrating non-inferiority of the low residue diet.

Dataset Information

Effect of single-day versus multi-day low-residue diet on colonoscopy bowel preparation: a systematic review and meta -analysis.

Introduction

Methods

Results

Conclusions

Publications

Effect of single-day versus multi-day low-residue diet on colonoscopy bowel preparation: a systematic review and meta -analysis.

Similar Datasets

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