Department of Gastroenterology, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal.
Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
United European Gastroenterol J. 2019 Dec;7(10):1321-1329. doi: 10.1177/2050640619883176. Epub 2019 Oct 15.
Although a 1-day low-fibre diet before colonoscopy is currently recommended, some endoscopists prescribe a 3-day diet.
The objective of this study was to compare the influence of a 3-day versus a 1-day low-fibre diet on bowel preparation quality, patient tolerability and adherence.
Outpatients scheduled for total colonoscopy were randomized in two groups, 3-day versus 1-day low-fibre diet, performing a 4-litre polyethylene glycol split-dose. The primary outcome was a reduction of inappropriate preparations in the 3-day low-fibre diet arm from 15% to 5% (bowel preparation was assessed by the Boston Bowel Preparation Scale). Secondary outcomes were adherence to, difficulty to perform, difficulty to obtain and willingness to repeat the diet. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome.
A total of 412 patients were randomized (206 per group). Bowel preparation quality was similar between groups. On ITT analysis ( = 412), adequate bowel preparation was 91.7% (3-day diet) versus 94.7% (1-day diet), = 0.24 and on PP analysis ( = 400) 93.5% versus 96.5%, respectively, = 0.16. Difficulty to perform the diet was significantly higher on the 3-day diet, = 0.04. No differences were found on difficulty to obtain the diet, willingness to repeat the diet, adverse events and intra-colonoscopy findings.
A 3-day low-fibre diet does not bring benefit to the bowel preparation quality and is harder to perform than a 1-day diet.
目前，结肠镜检查前建议采用 1 天低纤维饮食，但一些内镜医生会开 3 天的饮食处方。
本研究旨在比较 3 天与 1 天低纤维饮食对肠道准备质量、患者耐受性和依从性的影响。
拟行全结肠镜检查的门诊患者随机分为两组，3 天低纤维饮食组和 1 天低纤维饮食组，均采用 4 升聚乙二醇分剂量方案。主要结局是将 3 天低纤维饮食组中不适当的肠道准备比例从 15%降低到 5%（采用波士顿肠道准备量表评估肠道准备情况）。次要结局是饮食的依从性、执行难度、获取难度和重复意愿。对主要结局进行意向治疗（ITT）和符合方案（PP）分析。
共纳入 412 例患者（每组 206 例）。两组肠道准备质量相似。ITT 分析（ = 412）显示，3 天饮食组肠道准备充分率为 91.7%（3 天饮食）与 94.7%（1 天饮食）， = 0.24，PP 分析（ = 400）分别为 93.5%与 96.5%， = 0.16。3 天饮食组的饮食执行难度显著更高， = 0.04。在获取饮食的难度、重复饮食的意愿、不良事件和腔内镜下发现方面，两组无差异。
3 天低纤维饮食不能提高肠道准备质量，且比 1 天饮食更难执行。
