DIET FOR COLONOSCOPY PREPARATION Ditta Cempaka Pane,S.Gz Kolonoskopi • Metode diagnostik yang efektif dalam skrining : • • • • • kanker kolon haematochezia diare / konstipasi kronik anemia tanpa sebab yang jelas untuk evaluasi lebih lanjut adanya kelainan pada pe meriksaan colon in loop • Dapat melihat secara langsung struktur kolon d an melakukan pengambilan sampel jaringan mel alui biopsi untuk meneliti lebih lanjut kelainan ko lon tersebut. Kolonoskopi Persiapan kolonoskopi berbeda dengan persiap an endoskopi lainnya (dimana cukup dengan pua sa selama 6 jam saja). •Persiapan kolon yang ideal : • • pembersihan kolon dari materi feses dengan cepat • mudah tanpa menyebabkan perubahan makroskopis dan mikroskopis mukosa kolon • diet dapat dikonsumsi dan dievaluasi dalam waktu si ngkat • nyaman • tidak menyebabkan gangguan elektrolit Kolonoskopi •Persiapan usus pada kolonoskopi yang tidak bai k menyebabkan tidak bersihnya kolon sehingga dapat mengakibatkan lolosnya lesi pembatalan tindakan menambah waktu prosedur menambah seringnya komplikasi karena kurang tepa tnya keputusan diagnosa pasien • kurang tepatnya terapi selanjutnya. • • • • Diet utk Kolonoskopi • Secara umum klien diminta untuk diet rendah s erat selama 1-2 hari sebelum pemeriksaan • Istilah yang sering digunakan adalah makan bu bur kecap → pembatasan diet ini banyak yang ti dak disukai klien • In the United States, a clear liquid diet is usuall y recommended the day prior to the colonoscop y evaluation. This type of restrictive diet is not w ell liked among patients. Colonoscopy Diet A few days before The day before the The day of the the colonoscopy colonoscopy colonoscopy • Start a eating a • only clear liquids low-fiber diet • clear broth, black • no whole grains, coffee or tea, clear • clear liquid foods only • Don't eat or drink nuts, seeds, dried juice, clear soft anything two fruit, or raw fruits drinks hours before the or vegetables procedure. source: Harvard Health Publications, 2015 Low-Fiber Diet Three-two days before, eat only low-fiber foods Low-Fiber Diet Low-Fiber Diet Low-Fiber Diet Low-Fiber Diet Low-Fiber Diet Clear-Liquid Diet One day before and the day of colonoscopy Perbandingan Efektifitas Pemberian Bubur Kecap Dengan Tanpa Pemberian Bubur Kecap Terhadap Kebersihan Kolon Untuk Persiapan Tindakan Kolonoskopi • Metode: Quasi Experimental • Subjek: Dua kelompok yaitu kelompok dengan pemberian bubur kecap dan kelompok tanpa pemberian bubur kecap (@ (15 respon den) • Kualitas kolon dinilai menggunakan Boston Bowel Preparation Sc ale (BBPS). • Hasil : tidak ada perbedaan yang signifikan pd poin BPPS pemeri ksaan kolonoskopi antara klien dengan pemberian bubur kecap d engan tanpa pemberian bubur kecap A randomized controlled trial comparing a low-resid ue diet versus clear liquids for colonoscopy prepara tion: impact on tolerance, procedure time, and aden oma detection rate. Stolpman et al. J Clin Gastroenterol. 2014 Nov-Dec;48(10):851-5. • Method: prospective, blinded, randomized controlled trial of pati ents undergoing screening or surveillance colonoscopy • Bowel prep quality was scored using the Boston Bowel Preparati on Scale (BBPS). • Subject: 200 patients were randomized to a) b) a low-residue diet (LRD) for breakfast and lunch the day before the procedure or clear liquids (CLD) all day before the procedure Cont’d Results: • 96.5% of patients had a good or excellent bowel pre p (BBPS=6, 7, 8, or 9). • LRD prep quality was noninferior to CLD prep quality (LRD 7.8 vs. CLD 8.1). • Polyp detection rates were similar (68% vs. 65.4%, P= 0.6899). • Patient tolerance and acceptance did not differ. • Withdrawal times were equivalent between both grou ps (16.2 vs. 16.5 min, P=NS). Low-residue versus clear liquid diet before colonoscopy: a meta-analysis of randomized, controlled trials. Nguyen et al. Gastrointest Endosc. (2016) 83:499-507.e1. • Method: Publikasi dari Scopus, PubMed/MEDLINE, Cochrane, CI NAHL (Februari 2015) mengenai adult patients undergoing colono scopy examination and comparing LRD with CLD on the day befor e colonoscopy • Subjek: 9 penelitian dgn 1686 pasien Cont’d Results: • Patients consuming an LRD demonstrated significantl y higher odds of tolerability (OR 1.92; 95% CI, 1.36-2.7 0; P<0.01) compared with a CLD • Patients were more willing to have a repeat colonosc opy performed (OR 1.86; 95% CI, 1.34-2.59; P<0.01) • There is no differences in quality of bowel preparatio ns (OR 1,21; 95% CI, 0,64-2,28; P=0,58) • There is no differences in adverse effects (OR 0,88; 95 % CI, 0,58-1,35; P=0,57) Conclusion • A low-residue diet on the day before colonoscopy se ems to be better for patients and should be utilized m ore often for outpatient procedures. • However, for hospitalized patients, this diet may not be as effective given multiple other factors. In hospitali zed patients, a clear liquid diet was noted to be the on ly dietary modification that improved quality of colonic preparation.
