Low-Residue Diet Acceptable for Bowel Prep

Low-Residue Diet Acceptable for Bowel Prep | Medscape | by Caroline Helwick  May 23, 2016

For decades people have been tortured with extreme, almost violent, bowel prep procedures for their colonoscopies though a less intestinally traumatic method was possible all along.

A diet of low-residue solid foods the day before colonoscopy leads to more effective bowel cleansing than the traditional clear-liquid diet, new research shows.

And patients who followed the low-residue diet “were more comfortable in the 24 hours before the test,” said Jason Samarasena, MD, from the University of California, Irvine. They were “less hungry and less fatigued on the morning of the colonoscopy.”  

This finding is “good news for patients who dread the clear-liquid diet,” he said here at Digestive Disease Week 2016. For many people, dietary restrictions the day before colonoscopy are a deterrent to life-saving screening for colorectal cancer, he pointed out.

“This is an interim analysis,” he pointed out, “but the fact is that if patients can eat a low-residue diet, rather than just pure liquids, their satisfaction with and adherence to colonoscopy prep will be markedly improved.

Patients randomly assigned to the low-residue diet consumed small portions of solid foods, such as protein, carbohydrate, and fat, during meals up until 6:00 PM the day before the procedure.

Patients could choose foods such as eggs, yogurt, cheese, white bread, chicken breasts, and ice cream,” Dr Samarasena explained.

“These are foods that are easily liquefied in the small intestine, wash out easily with the prep agent, and therefore do not interfere with colonoscopy.”

Those randomly assigned to the clear-liquid diet could drink only broth, black coffee, black tea, and other clear liquids the day before the procedure.

All patients consumed two doses of PEG-ELS purgative — one dose at 6:00 PM the evening before the procedure and the other dose 5 hours before the procedure.

The low-residue diet performed better than the liquid diet on all measures, according to an interim analysis of the data.

What’s most astonishing is that a less extreme protocol not only equaled, but improved the results.

There are several reasons the low-residue diet might outperform the liquid diet, Dr Samarasena explained.

Solid foods might have given the patients more energy, which would help them tolerate the purgative, leading to better compliance and superior bowel cleansing. And solid foods might have stimulated natural bowel movements, so the purgative would have less work to do.

We hope our findings will change the way practitioners prepare patients for colonoscopy and increase the population of patients willing to participate in vital screening,” Dr Samarasena said.

“It’s a fascinating concept,” Dr Vargo told Medscape Medical News. “We have thought for so long that it has to be liquids or the highway, but this may not be the case. If we get positive results, this obviously would benefit our patients.”  

Congratulations, Dr. Vargo, for admitting that what you previously believed might be wrong.

Medicine is constantly changing as it advances so only those willing to admit they were previously “wrong” are able to understand and use the latest knowledge.

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