Recently, more studies have been performed by several institutions to compare the CLD and LRD however, the number of participants involved has been small. Therefore, many medical institutions have not adopted the LRD. Nonetheless, because of the lack of randomized controlled trials (RCTs) comparing the LRD and CLD in large populations, many physicians are not convinced of the effectiveness of the LRD. Furthermore, the potential risks of the CLD are unclear for those with gastrointestinal diseases. Moreover, the CLD may cause blood glucose fluctuations in patients with diabetes, thus affecting patient compliance ( Alvarez-Gonzalez et al., 2016). These results suggest the superiority of the LRD. Additionally, the LRD can be implemented 1 day before colonoscopy and does not require multiple days of use ( Gimeno-Garcia et al., 2019). Further studies have shown that the LRD can reduce the amount of purgative intake used during the CLD to achieve similar bowel cleansing ( Lee et al., 2019). Simultaneously, compared with the CLD, the LRD seems more easily accepted by patients, resulting in higher tolerance, satisfaction, and compliance ( Nguyen, Jamal, Nguyen, Puli, & Bechtold, 2016). However, some studies have shown that using the LRD was not inferior to using the CLD for bowel preparation. Traditionally, the CLD has been used before colonoscopy to ensure the quality of bowel preparation. Meanwhile, the tolerance of people with low-residue diet was better than people with clear liquid diet, and these people were more willing to repeat the colonoscopy with less adverse events. People who employed the low-residue diet before colonoscopy had the same quality of bowel preparation as those with clear liquid diet. More patients in the clear liquid diet group experienced hunger, nausea, and vomiting. More patients in the low-residue diet group were willing to repeat the low-residue diet for bowel preparation (odds ratio = 2.34 p <. However, patient tolerance to the low-residue diet was higher (odds ratio = 1.86 p <. The quality indicators for colonoscopy of the two groups were not statistically significant. 68) Ottawa Bowel Preparation Scale (standard mean difference =−0.04 p =. There was no statistically significant difference between the Boston Bowel Preparation Scale (standard mean difference =−0.04 p =. No statistically significant difference was observed between the low-residue diet and clear liquid diet groups (odds ratio = 1.19 p =. The statistical analysis was performed by using RevMan 5.3 software. After the systematic review of all 16 studies, the outcomes including quality of bowel preparation, tolerance, willingness to repeat, and adverse effects were analyzed through meta-analysis. A literature search for randomized controlled trials on the effects of employing the clear liquid diet and low-residue diets before colonoscopy was conducted in major online English databases (PubMed, Web of Science, and Ovid EMBASE). The goal of this systematic review was to compare the clear liquid diet and the low-residue diet to determine which is better for bowel preparation before colonoscopy.
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