American College of Gastroenterology Annual Meeting

American College of Gastroenterology Annual Meeting

Perspective from Hassan Siddiki, MD
November 13, 2019
3 min read

Low-residue diet improves bowel prep, patient tolerance

Perspective from Hassan Siddiki, MD
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SAN ANTONIO — Patients who adhered to a single-day, low-residue diet prior to colonoscopy had a better bowel preparation and reported better tolerance compared with a clear liquid diet, according to study results presented at the American College of Gastroenterology Annual Meeting.

Jason Samarasena, MD, FACG, of the University of California, Irvine, Medical Center said that patients often say that diet restrictions and the bowel prep process can deter them from undergoing colonoscopy.

“Despite data supporting the use of low-residue diet over a clear liquid diet regimen, adoption in the U.S. has been slow,” Samarasena said in this presentation. “Our aim was to compare single-day, low-residue diet to clear liquid diet before bowel preparation with regard to bowel cleansing quality, toleration and satisfaction among a diverse U.S. patient population.”

In a dual center, randomized, single-blinded study, researchers randomly assigned patients who underwent colonoscopy to consume either a low-residue (n = 90) or clear liquid (n = 80) diet in the day prior to their procedure. For the low-residue diet, investigators provided patients with a list of food options for each meal of the day that included a protein, a carbohydrate and a fat. Both groups of patients consumed a 4-liter, split dose bowel prep prior to their colonoscopy.

Patients in the low-residue and clear liquid diet groups has similar mean BBPS (7.98 vs. 7.54). However, there was a higher number of adequate preparations in the low-residue group, defined as a BBPS great than 6 with no individual segment less than 2 (91.3% vs. 75.7%; P = .05).

Compared with clear liquid diet, patients in the low-residue diet group had lower evening hunger scores on a 10-point scale (7.03 vs. 5.5; P = .006), and had less nausea and bloating.

Additionally, patients in the low-residue group reported higher satisfaction (100% vs. 33%; P < .001) and a better overall colonoscopy experience compared with patients who consumed a clear-liquid diet.

Samarasena said their findings show that patients who use a low-residue diet before colonoscopy achieve bowel preparation that may be superior to patients on a clear liquid diet.

“These results are in line with the most recent guidelines on bowel preparation which endorse the use of low-residue diet prior to colonoscopy,” he said. “As a less restrictive dietary regimen, low-residue diet may help negate patient concerns about the bowel preparation experience and potentially improve participation in colorectal cancer prevention programs.” – by Alex Young


Samarasena J, et al. Abstract 68. Presented at: American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.

Disclosures: Samarasena reports no relevant financial disclosures.