IDDF2018-ABS-0040 Efficacy of low residue diet versus clear liquid diet for colonoscopy bowel preparation in special populations (elderly, diabetics, chronic kidney disease and chronic liver disease patients): a single-blinded randomised non-inferiority controlled trial

Abstract

Background Ineffective bowel cleansing for colonoscopy results in missed precancerous lesions and increased cost related to early repeat procedures. Better tolerability of bowel preparation may improve patient‘s compliance and experience and may potentially improve their future participation in colorectal cancer prevention programs without compromising examination quality. The study aims to determine the efficacy and tolerability of low residue diet (LRD) on colonoscopy bowel preparation on special populations compared with the traditional clear liquid diet (CLD). Methods This study was a prospective single-blinded, randomised controlled non-inferiority trial. A total of 150 patients were included in the analysis. Patients were randomised to receive a low residue diet or a clear liquid diet. The primary outcome is the efficacy or adequacy of bowel preparation and was measured by the Boston Bowel Preparation Score (BBPS). Patient‘s tolerability, hunger score and overall satisfaction were assessed as secondary outcomes. Results Low residue diet (LRD) bowel preparation was non-inferior to Clear liquid diet (CLD) bowel preparation (LRD 7.00 vs CLD 6.9 p=0.7724). Overall, patient‘s tolerability and satisfaction were better in the LRD group than the CLD group. The present study showed that the proportion of patients having abdominal pain/cramping/discomfort and bloatedness were significantly lower in the LRD group (16% and 26.7%) compared to CLD group (34.7% and 44%). Conclusions Patients on an LRD for bowel preparation achieved an adequate bowel preparation that is non-inferior to patients on a CLD. Furthermore, the study showed that patients‘ tolerability and overall satisfaction were better on the LRD and more willing to repeat the same bowel regimen as compared to CLD.