Abstract
Background Optimal bowel preparation for colonoscopy is fundamental to a successful examination. The FODMAP diet can increase the content of intestinal water and gas, but its impact on bowel cleanliness and bubbles has not been reported. This study was therefore aimed at evaluating the effect of the FODMAP diet on the quality of bowel preparation and the adenoma detection rate (ADR). Methods This was a multicenter, prospective cohort study involving consecutive patients who underwent colonoscopy in two centers in China. Patients were assigned to one of two groups: high-FODMAP or nonhigh-FODMAP diet. ODMP Software was used for the identification of FODMAP diet types. The primary outcome was ADR; secondary outcomes were the quality of bowel preparation, measured by the Boston bowel preparation scale and bubble scores. Results There were 365 patients included. Patients in the high-FODMAP-diet group showed poor bowel cleansing efficacy: BBPS ≥ 6 in 76.8% vs. 90.3% (P < 0.01) and bubble scores of 2.42 ± 1.69 vs. 1.32 ± 1.63 (P < 0.001). The intubation time was significantly longer in the high-FODMAP-diet group (7.07 ± 5.18 vs. 5.46 ± 3.05 min; P = 0.002). The High-FODMAP diet was an independent risk predictor for inadequate bowel preparation. There were no statistically significant differences in ADR between the two dietary groups. Conclusion The high-FODMAP diet significantly reduced the quality of bowel preparation. We recommend the consumption of nonhigh-FODMAP diet in bowel preparation as a reference standard for dietary regimen. This method was effective, flexible, referable, and well tolerated, which could help to provide patients a valuable dietary guidance in bowel preparation.
Highlights
Colorectal cancer (CRC) contributes significantly to mortality related to cancer worldwide
A total of 241 patients were assigned to the high-FODMAP-diet group and 124 to the nonhighFODMAP-diet group based on the diet information recorded on the food diary card and the diet types identified by ODMP Software
High-quality bowel preparation is a prerequisite for successful colonoscopy
Summary
Colorectal cancer (CRC) contributes significantly to mortality related to cancer worldwide. This study was aimed at evaluating the effect of the FODMAP diet on the quality of bowel preparation and the adenoma detection rate (ADR). Patients in the high-FODMAP-diet group showed poor bowel cleansing efficacy: BBPS ≥ 6 in 76.8% vs 90.3% (P < 0:01) and bubble scores of 2:42 ± 1:69 vs 1:32 ± 1:63 (P < 0:001). We recommend the consumption of nonhigh-FODMAP diet in bowel preparation as a reference standard for dietary regimen. This method was effective, flexible, referable, and well tolerated, which could help to provide patients a valuable dietary guidance in bowel preparation
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