Özer Etik Diğdem, Suna Nuretdin, Gündüz Cemre, Bostan Ahmet, Özdemir Alperen, Gürel Bade Yağmur, Yenişekerci Ezgi, Boyacıoğlu Ahmet Sedat
Department of Gastroenterology, Başkent University School of Medicine, Ankara, Turkey.
Department of Internal Disease, Başkent University School of Medicine, Ankara, Turkey.
Turk J Gastroenterol. 2019 Sep;30(9):817-825. doi: 10.5152/tjg.2019.19071.
BACKGROUND/AIMS: A successful screening colonoscopy is closely linked to the quality of a bowel preparation. In this study, we aimed to determine the impact of a 1-day clear liquid diet (CLD) compared to a 3-day combined diet (CMD) accompanied by a split-dose regimen of polyethylene glycol and electrolyte lavage solution (PEG-ELS) for screening colonoscopy.
This was a prospective, randomized, endoscopist-blinded study. Patients referred for screening colonoscopy were randomized to four groups as a 1-day CLD+PEG-ELS vs. a 1-day CLD+sulfate free (SF)-PEG-ELS and a 3-day CMD+PEG-ELS vs. a 3-day CMD+SF-PEG-ELS. An assessment of the quality of colon cleaning, tolerability to the preparation, and symptoms related to the preparation were recorded.
A total of 506 patients were enrolled in this study. The quality of bowel preparation was significantly inferior in the CMD+PEG-ELS group than CLD+PEG-ELS (p=0.004) and CMD+SF-PEG-ELS groups (p=0.007). There were no statistical differences among the groups in terms of the polyp detection rate. With respect to an easy rating of diet following and the consumption of laxative, there were no significant differences among the four groups. Gastric fullness and nausea/vomiting were pointed out much more, especially in the SF-PEG-ELS users (p=0.008 and p=0.004, respectively).
A 1-day CLD was not inferior to a 3-day CMD for colonoscopy preparation in terms of bowel cleaning, the polyp detection rate, and patient tolerance.
背景/目的：成功的结肠镜筛查与肠道准备质量密切相关。在本研究中，我们旨在确定与采用聚乙二醇和电解质灌洗液（PEG-ELS）分剂量方案的3天联合饮食（CMD）相比，1天清流食饮食（CLD）对结肠镜筛查的影响。
这是一项前瞻性、随机、内镜医师盲法研究。因结肠镜筛查就诊的患者被随机分为四组：1天CLD + PEG-ELS组与1天CLD + 无硫酸盐（SF）-PEG-ELS组，以及3天CMD + PEG-ELS组与3天CMD + SF-PEG-ELS组。记录结肠清洁质量、对准备措施的耐受性以及与准备措施相关的症状评估情况。
本研究共纳入506例患者。CMD + PEG-ELS组的肠道准备质量显著低于CLD + PEG-ELS组（p = 0.004）和CMD + SF-PEG-ELS组（p = 0.007）。各组之间的息肉检出率无统计学差异。在饮食依从性和泻药服用情况的简易评分方面，四组之间无显著差异。胃部饱胀感和恶心/呕吐情况被指出更多，尤其是在使用SF-PEG-ELS的患者中（分别为p = 0.008和p = 0.004）。
就肠道清洁、息肉检出率和患者耐受性而言，1天CLD在结肠镜检查准备方面不劣于3天CMD。
