Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gut Liver. 2013 Nov;7(6):681-7. doi: 10.5009/gnl.2013.7.6.681. Epub 2013 Aug 14.
BACKGROUND/AIMS: A dietary regimen consisting of a clear liquid diet (CLD) for at least 24 hours is recommended for colonoscopy preparation. However, this requirement results in problems in patient compliance with bowel preparation. The aim of this study was to evaluate the efficacy of a CLD compared with a regular diet (RD) for colonoscopy preparation using a polyethylene glycol (PEG) solution.
This was a multicenter, randomized, investigator-blind prospective study. A total of 801 healthy outpatients undergoing afternoon colonoscopy were randomized to either a CLD or RD in addition to a 4 L PEG regimen.
The quality of bowel cleansing was not different between the CLD and RD groups in terms of the proportion with excellent or good preparation. In addition, no significant differences were observed between the two groups for polyp and adenoma detection rates and overall adverse events. Good compliance with bowel preparation was higher in the RD group than in the CLD group.
A CLD for a full day prior to colonoscopy should not be mandatory for PEG-based bowel preparation. Dietary education concerning the avoidance of high-fiber foods for 3 days before colonoscopy is sufficient, at least for healthy outpatients.
背景/目的：结肠镜检查前至少 24 小时的清流质饮食（CLD）是推荐的饮食方案。然而，这一要求导致患者在肠道准备方面的依从性出现问题。本研究旨在评估 CLD 联合聚乙二醇（PEG）溶液与常规饮食（RD）在结肠镜准备中的效果。
这是一项多中心、随机、观察者盲法前瞻性研究。共有 801 例健康的下午行结肠镜检查的门诊患者被随机分为 CLD 组或 RD 组，两组均在 PEG 方案的基础上进行肠道准备。
在肠道清洁质量方面，CLD 组和 RD 组在优秀或良好准备的比例方面没有差异。此外，两组在息肉和腺瘤检出率以及总体不良事件方面也没有显著差异。RD 组的肠道准备良好依从性明显高于 CLD 组。
对于 PEG 为基础的肠道准备，结肠镜检查前全天的 CLD 不应该是强制性的。对于结肠镜检查前 3 天避免高纤维食物的饮食教育是足够的，至少对健康的门诊患者是如此。
