Chandni Kapoor, MD1, Sherry Zhang, MD1, Nirmala Ramalingam, MPP2, Mitchell Liverant, MD1, Lawrence Ku, MD1, Benjamin Hassid, MD1 1Kaiser Permanente, Oakland, CA; 2Kaiser Permanente Oakland Medical Center, Oakland, CA
Introduction: Studies have shown no difference in bowel preparation quality with a one-day low residue diet prior to colonoscopy, with increased patient tolerance and willingness to repeat the preparation process. Our quality improvement project aims to assess whether a difference exists in bowel preparation quality with a clear liquid diet (CLD) compared to a low residue diet (LRD).
Methods: Between 2022 and 2024, adults 18 years and older undergoing a colonoscopy at Kaiser Permanente East Bay were initially assigned CLD or LRD; after an initial pilot, all patients henceforth were assigned to LRD. Patient centered questions were posed regarding the bowel preparation process, ease of following the pre-colonoscopy diet, and any comments (Table). The endoscopist performing the colonoscopy rated bowel preparation quality [“1-Poor Prep, 2-Fair, 3-Good, 4-Excellent"]. Subjects were excluded if type of diet or the physician rating was not present. The modified Likert scale variables were grouped into two categories (1&2 and 3&4) for analysis. The Chi-square test of significance was performed to a significance cutoff of 0.05.
Results: In total, 640 patients had colonoscopies; 55% of patients prepared with CLD and 45% prepared with LRD. Although later patients were instructed to prepare with LRD, 202 patients implemented CLD. In the CLD group, the overall experience was rated 3.7 ± 1.0 (3= Fair), how easy to follow diet 3.7 ± 0.8 (3= Tolerable), preparation rating 3.1 ± 0.7 (3= Good). In the LRD group, the overall experience was rated 3.8 ± 0.9, how easy to follow diet 3.7 ± 0.8, preparation rating 3.2 ± 0.7. Overall experience did not differ between groups (X2 =3.6, p=0.31), nor did ease of diet (X2 =3.0 p=0.38). Bowel preparation rating did not differ by LRD or CLD (X2=1.1, p> 0.05). Patient comments on the CLD group focused primarily on the amount of liquid, some commenting about the empty stomach, whereas comments in the LRD group focused on needing more clarity on what could be eaten.
Discussion: Our project, with a large cohort of 640 patients, showed no difference in preparation rating with LRD compared to the standard CLD. Patient experience and ease with LRD was equivalent to those with CLD. Further research can explore the trends in colonoscopy rates with broader implementation of LRD.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Chandni Kapoor indicated no relevant financial relationships.
Sherry Zhang indicated no relevant financial relationships.
Nirmala Ramalingam: Baxter – Stock-publicly held company(excluding mutual/index funds). Jazz Pharmaceuticals – Stock-publicly held company(excluding mutual/index funds).
Mitchell Liverant indicated no relevant financial relationships.
Lawrence Ku indicated no relevant financial relationships.
Benjamin Hassid indicated no relevant financial relationships.
Chandni Kapoor, MD1, Sherry Zhang, MD1, Nirmala Ramalingam, MPP2, Mitchell Liverant, MD1, Lawrence Ku, MD1, Benjamin Hassid, MD1. P0412 - Keeping You Full and Clear: Low Residue Diet Prior to Colonoscopy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
