BACKGROUND AND AIMS: Colonoscopy is extremely important for identification and removal of pre-cancerous polyps. Before colonoscopy, bowel preparation is essential for adequate visualization. Traditionally, patients have been instructed to consume clear liquids the day before a colonoscopy. However, recent studies have suggested, with varying results, using a low-residue diet. We evaluated the outcomes on patients undergoing colonoscopy with clear liquid diet (CLD) versus low-residue diet (LRD) on the day before colonoscopy by meta-analysis.
METHODS: Scopus, PubMed/MEDLINE, Cochrane databases, and CINAHL were searched (February 2015). Studies involving adult patients undergoing colonoscopy examination and compared LRD versus CLD on the day before colonoscopy were included. The analysis was conducted using the Mantel-Haenszel or DerSimonian and Laird models with odds ratio (OR) assessing for adequate bowel preparations, tolerability, willingness to repeat diet and preparation, and adverse effects.
RESULTS: Nine studies were included (N = 1686). Patients having a low-residue diet as compared with clear liquids demonstrated significantly higher odds of tolerability (OR 1.92; 95% CI, 1.36-2.70; p<0.01) and willingness to repeat preparation (OR 1.86; 95% CI, 1.34-2.59; p<0.01) with no differences in adequate bowel preparations (OR 1.21; 95% CI, 0.64-2.28; p=0.58) or adverse effects (OR 0.88; 95% CI, 0.58-1.35; p=0.57).
CONCLUSIONS: LRD before colonoscopy resulted in improved tolerability of patients and willingness of patients to repeat preparation with no differences in preparation quality and adverse effects.