Favorable outcomes of prepackaged low‐residue diet on bowel preparation for colonoscopy: Endoscopist‐blinded randomized controlled trial

Abstract

2L polyethylene glycol plus an ascorbic acid (PEGA) is known to be as effective. However, 2L polyethylene glycol-based regimens are often still difficult for patients to tolerate. Therefore, we conducted this study to evaluate the potential of 1L PEGA with prepackaged low-residue diet (PLD) as an alternative to 2L PEGA before colonoscopy. The subjects were randomly assigned to either of the two groups. The 2L PEGA group received 2L PEGA split regimen. The 1L PEGA with PLD group received PLD on the day preceding colonoscopy and 1L PEGA. All endoscopic procedures were performed by one physician who did not know patients allocation. Bowel preparation status were graded using Boston Bowel Preparation Score (BBPS). A questionnaire regarding tolerability and safety was administered. This trial is registered at ClinicalTrials.gov (NCT03329339). A total of 173 patients completed the study (86 in the 2L PEGA group and 87 in the 1L PEGA with PLD group). Bowel preparation was adequate in 88.4% (76/86) of patients in the 2L PEGA group and 93.1% of patients in the 1L PEGA with PLD group (81/87, P=0.28). The patients in the 1L PEGA with PLD group had higher whole Boston Bowel Preparation Scale score (P=0.02) and expressed more satisfaction and willingness to repeat the procedure (P<0.01). There was no significant difference with respect to compliance or safety. 1L PEGA with PLD showed equivalent efficacy, greater satisfaction, and more willingness to repeat compared with 2L PEGA for bowel preparation.