Optimizing Adequacy of Bowel Cleansing for Colonoscopy

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Optimizing Adequacy of Bowel Cleansing for Colonoscopy

Diet During Bowel Cleansing


Recommendation

Traditionally, patients are instructed to ingest only clear liquids the day before colonoscopy. Recent randomized trials report that a liberalized diet the day before colonoscopy is associated with better tolerance of the preparation and comparable or better bowel cleansing. The diet regimens in these trials were variable and included a regular diet until 6 PM, regular breakfast, low-residue breakfast, lunch and snack, a soft diet, and a semiliquid diet (heterogeneity: P=.008; I=62%). With this degree of heterogeneity we are reluctant to recommend a regular diet the day before colonoscopy. Accordingly, a low-residue diet for part or all of the day before colonoscopy can be considered for patients without other identifiable preprocedural risks for inadequate colon preparation. Pending additional study, colonoscopists carefully should evaluate any compromise in efficacy if dietary flexibility is allowed.

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