A Comparative Study On The Effect Of Prepackaged Diet And Self Made Low-residue Diet On Colonoscopy

Objective: Colonoscopy has been recognized as the gold standard for the diagnosis and treatment of colonic diseases,which is an important means of screening for colon cancer.The success or failure of colonoscopy depends largely on the quality of the bowel preparation.The ideal intestinal preparation should be able to effectively empty the contents of the intestinal cavity,ensuring the doctor’s careful observation of the intestinal mucosa under the microscope,as well as convenient and comfortable,and would not cause serious adverse reactions.At present,the study on intestinal preparation in China is mainly focused on the type,dosage,timing and auxiliary drug of intestinal cleaning agents,but few research about the effect of diet on the quality of intestinal preparation.Therefore,by comparing the effect of pre-packaged food and self-contained low residue food on the quality of intestinal preparation,this study investigate the difference of two groups in different aspects including intestinal cleanliness,defecation change,side reaction,polyp detection rate and medical staff satisfaction,to evaluate the efficacy,safety and tolerability of this scheme,thus to provide a theoretical basis for the clinical intestinal preparation.Methods: In this study,155 patients who accepted the colonoscopy from January 2016 to June 2016 in General Hospital of Armed Police are taken as research objects,and are divided into two groups by method of random.that is,the pre-packaged group and the self-provided group,respectively,and the single center,single blind,prospective and controlled study are conducted.The patients of pre-packaged group(group of pre-packaged diet)took pre-packaged food three meals a day before the examination,while the patients of self-provided group(the low-residue diet group)took low-residue diet provided by themselves one day before the examination.Intestine-rinsing fluid for both groups uses 3L Sulfate-free Polyethylene Glycol Electrolyte Powder and patients took them orally at 4:00 in the morning on the day of examination.Through Ottawa bowel preparation scale(OBPS),the intestinal tract cleanesses of patients of different groups are compared.Information on the side effect,the dietary adherence and the degree of patients’ satisfaction about pre-packaged diet and Sulfate-free Polyethylene Glycol Electrolyte Powder is collected through the questionnaire.The blood glucose change is monitored by collecting venous blood to evaluate the applicability of pre packaged diet for patients with diabetes.SPSS 17.0 software was adoptd for statistical analysis.The two groups of measurement data are represented using mean ± standard deviation(± S),and the independent-samples T test is adopted for the groups,and it is statistically significant if P is smaller than 0.05.Results:5 patients were removed from the experiment after the colonoscopy is completed.Finally,150 patients(75 patients in pre-packaged group,and 75 patients in self-provided group)are included in the finaly analysis.The enteroscope reached ileocecal junction,and there was no significant difference between the two groups in the basic data of patients(gender,age,body mass index,constipation history,colonoscopy,history of diabetes).1 Main evaluation indicators1)Intestinal tract cleaness.For the pre-packaged group,the total score(3.13±1.41)by Ottawa bowel preparation scale is lower than the score of self-provided group,the intestinal tract cleaness of pre-packaged group is higher than that of self-provided group,and the difference was statistically significant(P <0.05).For the pre-packaged group,the left colon scored(0.75± 0.55),while the self-provided group scored(1.24±0.45)(P<0.05),and there was significant difference between the two groups;in terms of transverse colon,the pre-packaged group scored(1.11±0.52)while the self-provided group scored(0.78±0.44)(P>0.05).There was no significant difference between the two groups;in terms of liquid quantity,the pre-packaged group scored(0.82±0.69)while the self-provided group scored(1.24±0.67).There was no significant difference between the two groups(P>0.05).In terms of bowel preparation,the percent of pass reached 88% in the pre-packaged group while the percent of pass reached 69% in the self-provided group.There was significant difference between the two groups(P<0.05).2)defecation,including first defecation time and defecation times In terms of the first defecation time,the pre-packaged group scored 46.25±28.23,which was significantly lower than that of self-provided group(65.34± 34.54)(P<0.05);in terms of colonoscopy time,the pre-packaged group scored(5.35±1.63)is lower than that of self-provided group(8.24±2.26)(P<0.05).3)Discovery rate of polypus.In terms of discovery rate of polypus,the pre-packaged group is 37.3% while the self-provided group is 32.0%.There is no significant difference between the two groups(P>0.05).2 Secondary evaluation indicators1)dietary adherence and side effect.The dietary adherence of patients in pre-packaged group reached 94.7% while that of self-provided group just reached 69.3%(P<0.05).86.7% of patients in the pre-packaged group would like to repeat the diet program while only 60.0% of patients in the self-provided group were willing to repeat the diet program,so the difference was significant(P <0.05);in terms of side effects,there are 15 cases of nausea,9 cases of vomiting,6 cases of abdominal pain,3 cases of abdominal distension,4 cases of dizziness and 5 cases of fatigue in the pre-packaged group;there are 18 cases of nausea,10 cases of vomiting,8 cases of abdominal pain,2 cases of bloating,6 cases of dizziness,8 cases of fatigue in the self-provided group.There is no significant difference between the two groups(P> 0.05).2)The degree of satisfaction of the medical staff.All the endoscope physicians and outpatient doctors as well as nurses were investigated,and the results showed that their degree of satisfaction about the diet of pre-packaged group reached 100%,and their degree of satisfaction about the diet of self-provided group are 45.5%(P<0.05),56.0%(P<0.05)and 33.6%(P<0.05)respectively.3)The blood glucose by colonoscopy and the fasting blood-glucose were monitored and compared for the diabetic patients,and the results showned that there were no great fluctuations or hypoglycaemia reaction.Conclusions:1 The prepackaged diet is safe and effective for colonoscopy preparation,and the intestinal cleanliness is better than that of the self made low-residue diet group.2 The prepackaged diet can shorten the time of first defecation,reduce the frequency of defecation,shorten the time of colonoscopy entering,improve the quality of colonoscopy as well.3 The prepackaged diet can improve the compliance of the patient’s diet preparation,simultaneously improve the satisfaction of patients and medical staff.