Abstract
Objectives
To investigate whether diet restriction affects quality of colon cleansing and patient tolerance during reduced bowel preparation for CT colonography (CTC).
Methods
Asymptomatic and symptomatic patients were enrolled in this pragmatic, single-centre, randomised trial. All patients were randomly assigned (1:1 ratio, blocks of ten) to receive a reduced bowel preparation and faecal tagging with (Diet-Restriction-Group [DR]) or without (No-Diet-Restriction-Group [NDR]) dietary restriction. Five readers performed a blinded subjective image analysis, by means of 4-point Likert-scales from 0 (highest score) to 3 (worst score). Endpoints were the quality of large bowel cleansing and tolerance to the assigned bowel preparation regimen. The trial is registered at ClinicalTrial.gov (URomLSDBAL1).
Results
Ninety-five patients were randomly allocated to treatments (48 in NDR-group, 47 in DR-group). Both groups resulted in optimal colon cleansing. The mean residual stool (0.22, 95%CI 0.00-0.44) and fluid burden (0.39, 95%CI 0.25-0.53) scores for patients in DR-group were similar to those in patients in NDR-group (0.25, 95%CI 0.03-0.47 [p = 0.82] and 0.49, 95%CI 0.30-0.67 [p = 0.38], respectively). Tolerance was significantly better in NDR-group.
Conclusion
A reduced bowel preparation in association with faecal tagging and without any dietary restriction demonstrated optimal colon cleansing effectiveness for CTC, providing better patient compliance compared with dietary restriction.
Key points
• Dietary restriction in reduced bowel preparation regimen can be avoided.
• The quality of colon cleansing is not affected by dietary restriction.
• The quality of faecal tagging is not affected by dietary restriction.
• Avoidance of dietary restriction improves patients’ tolerance for CTC.
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Abbreviations
- CTC:
-
Computed tomography colonography
- DR:
-
Diet-restriction
- NDR:
-
No-diet-restriction
- OC:
-
Optical colonoscopy
- USPSTF:
-
US Preventive Services Task Force
- VAS:
-
Visual analogue scale
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Acknowledgements
Part of this original work has been presented at RSNA 2016.
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The scientific guarantor of this publication is Andrea Laghi.
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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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A professional statistician kindly provided statistical advice for this manuscript.
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Written informed consent was obtained from all subjects (patients) in this study.
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Institutional Review Board approval was obtained.
Methodology
• prospective
• randomised controlled trial
• performed at one institution
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Bellini, D., De Santis, D., Caruso, D. et al. Bowel preparation in CT colonography: Is diet restriction necessary? A randomised trial (DIETSAN). Eur Radiol 28, 382–389 (2018). https://doi.org/10.1007/s00330-017-4997-3
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DOI: https://doi.org/10.1007/s00330-017-4997-3