Clin Endosc.  2025 Jan;58(1):63-76. 10.5946/ce.2024.061.

One-day low-residue diet is equally effective as the multiple-day low-residue diet in achieving adequate bowel cleansing: a meta-analysis of randomized controlled trials

• Putri RD
• Amalia F
• Utami FA
• Pamela Y
• Syamsunarno MRA

• KMID: 2564018
• DOI: http://doi.org/10.5946/ce.2024.061

Abstract

Background/Aims
Colonoscopy is widely used as a diagnostic and preventive procedure for colorectal diseases. The most recent guidelines advocate the use of a low-residue diet (LRD) for bowel preparation before colonoscopy. LRD duration varies considerably, with recommended 1-day and multiple-day regimens in clinical practice.
Methods
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched multiple databases for randomized controlled trials (RCTs) and analyzed the outcomes using a fixed-effects model.
Results
Six RCTs with 2,469 subjects were included in this study. The rates of adequate bowel preparation for 1-day and >1-day were 87.2% and 87.1%, respectively. No statistically significant differences were observed between the 1-day and >1-day LRD in adequate bowel preparation (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.76–1.41; p=0.84; I2=0%), polyp detection rate (OR, 0.91; 95% CI, 0.76–1.09; p=0.29; I2=16%), adenoma detection rate (OR, 0.87; 95% CI, 0.71–1.08; p=0.21; I2=0%), and withdrawal time (mean difference, –0.01; 95% CI, –0.25 to 0.24; p=0.97; I2=63%).
Conclusions
The efficacy of 1-day and multiple-day LRD is comparable in achieving satisfactory bowel preparation, highlighting their similar impact on the detection of polyps and adenomas during colonoscopy.

Keyword

Bowel preparation; Colonoscopy; Colonoscopy quality; Colorectal cancer screening; Low residue diet

Figure

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  Fig. 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of study screening and selection.

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  Fig. 2. (A) Comparison of adequate bowel preparation rate between 1-day and 3-day low-residue diet (LRD) group. (B) Comparison of mean Boston bowel preparation scale between 1-day and 3-day LRD group. M-H, Mantel–Haenszel; CI, confidence interval.

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  Fig. 3. Comparison between 1-day and 3-day low-residue diet (LRD) group in polyp detection rate (A), adenoma detection rate (B), withdrawal time (C), cecal intubation rate (D), and cecal intubation time (E). M-H, Mantel–Haenszel; CI, confidence interval.

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  Fig. 4. Risk of bias assessment of the included studies in the meta-analysis using Cochrane Risk-of-Bias 2 tool.

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  Fig. 5. (A) Funnel plot for Boston bowel preparation scale of the included studies. (B) Funnel plot for polyp detection rate of the included studies.

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