Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa.
Colorectal Unit, Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa.
S Afr J Surg. 2020 Dec;58(4):217.
Bowel preparation is essential for quality colonoscopy. Although most bowel preparation regimens recommend dietary restriction for 24 to 48 hours before the procedure, the evidence for this is poor. This study aimed to investigate whether dietary restriction during bowel preparation improves the quality of colonoscopy.
A prospective, randomised controlled pilot study in which the dietary restriction (DR) group (control) was instructed not to ingest high fibre foods for 48 hours prior to the use of a polyethylene glycol (PEG) bowel preparation. The non-dietary restriction (NDR) group were given no dietary instruction but received instructions for the use of the PEGbased preparation. On the day of colonoscopy, the quality of the bowel effluent was assessed, and additional preparation given as necessary. The primary endpoint was quality of bowel cleansing using the Harefield Cleansing Scale during colonoscopy. The secondary endpoints were the need for additional bowel preparation and the quantity of additional bowel preparation given prior to endoscopy. Data were analysed on an intention to treat basis.
Twenty-three participants were randomised to the intervention group and thirty-four to the control group. Patient demographics were similar in both groups. Dietary restriction did not influence the success rate of bowel preparation: 97% successful bowel preparation in the DR group, vs 91% successful bowel preparation in the NDR group ( = 0.559). Additional bowel preparation requirement were similar in both groups: 35% in the DR group vs 39% in the NDR group ( = 0.768). Mean amount of additional bowel preparation required was similar: 560 ml in the DR group vs 460 ml in the NDR group ( = 0.633).
The quality of bowel preparation was comparable in patients with and without dietary restrictions prior to colonoscopy. Non-restrictive diets prior to bowel preparation should be considered to increase compliance. The sample size of this pilot study prohibited definite statistical conclusions but demonstrated this to be a reasonable methodology for a larger study.
肠道准备对于高质量的结肠镜检查至关重要。尽管大多数肠道准备方案建议在检查前 24 至 48 小时限制饮食，但这方面的证据不足。本研究旨在探讨肠道准备期间的饮食限制是否能提高结肠镜检查的质量。
这是一项前瞻性、随机对照的初步研究，其中饮食限制（DR）组（对照组）在使用聚乙二醇（PEG）肠道准备前的 48 小时内被指示不要摄入高纤维食物。非饮食限制（NDR）组未接受饮食指导，但接受了 PEG 肠道准备的使用说明。在结肠镜检查当天，评估肠道流出物的质量，并根据需要给予额外的准备。主要终点是使用 Harefield 清洁量表在结肠镜检查期间评估肠道清洁的质量。次要终点是需要额外的肠道准备和在结肠镜检查前给予的额外肠道准备的数量。数据基于意向治疗进行分析。
23 名参与者被随机分配到干预组，34 名参与者被分配到对照组。两组患者的人口统计学特征相似。饮食限制并不影响肠道准备的成功率：DR 组 97%的肠道准备成功，而 NDR 组 91%的肠道准备成功（=0.559）。两组的额外肠道准备需求相似：DR 组 35%，NDR 组 39%（=0.768）。所需的额外肠道准备量相似：DR 组 560 毫升，NDR 组 460 毫升（=0.633）。
在结肠镜检查前有或没有饮食限制的患者肠道准备质量相似。在肠道准备前应考虑非限制性饮食以提高依从性。这项初步研究的样本量限制了明确的统计学结论，但证明了这是进行更大规模研究的合理方法。
