Dear Zhongliujun, doing colonoscopy is really a foodie's robbery, I am careful with my diet before and after, I am not finished cutting polyps, and I am even more constrained in my diet. As a northerner, I can't do without the obsession with steamed buns, I don't eat a meal, and my fatigue is short; I didn't eat for three days, and I missed it very much. What can I eat after the polyp is cut after colonoscopy? Can you eat steamed buns?
People take food as the sky, and it is more significant before and after colonoscopy! In the past, I had to worry about eating less or not eating for three days before colonoscopy, and after drinking laxatives, I began to worry about being hungry enough to stand the examination, worried about when I would be able to eat after the examination, and worried about eating too much after cutting polyps, and whether the wound would grow if I ate the wrong one. This time and again, you may not be able to eat and drink freely for a week or two, and it is even more difficult for friends who love steamed buns. Because of this, the acceptance of colonoscopy has decreased a bit!
Colonoscopists should have some of these concerns!
In this regard, we split the analysis.
How long does it take to control your diet before the exam?
For better bowel preparation, dietary restriction is a must! What are dietary restrictions? This refers to a low-fiber diet, such as steamed buns, noodles, eggs, and fish, while vegetables, fruits, and indigestible clumps such as celery, cereal, and dragon fruit are high-fiber diets. There is a well-established answer to everyone's concern about the need to restrict your diet for a few days before starting to drink laxatives: a low-fiber diet is enough for 1 day before the test!
The authoritative journal Endoscopy compared the low-fiber diet 1 day before surgery and 3 days before surgery, and found that there was no difference in the degree of intestinal cleanliness between the two, so the shorter the dietary restriction time, the better the compliance and tolerance of patients, which is consistent in the European bowel preparation guidelines and the Chinese guidelines.
There are three tiers to a low-fiber diet.
According to the "Guidelines for Intestinal Preparation Related to Digestive Endoscopy and Treatment in China (2019, Shanghai)", 28 times of "dietary restrictions" have been repeatedly emphasized, and the content is very simple. If you feel too hungry, you can use low-fiber foods such as noodles, eggs, and steamed buns, and the effect of intestinal preparation is similar to that of porridge soup; If you still feel too hungry, buy a bag of special bowel preparation meals, also known as "meal replacements", to increase acceptance. Two of these keywords: "meal replacement" and "steamed bun".
Excessively restrictive dietary restrictions can bring a variety of drawbacks, including hunger, fatigue, palpitation, and low blood sugar. It is more difficult for older and frail people with poor nutritional status to tolerate it, and the lack of nutrients and energy can lead to many problems such as decreased tissue healing. "Meal replacement" came into being, refers to a variety of complex food bagged into a meal, a treasure meal replacement has a wide variety, there are ** meal replacement, special disease meal replacement, luxury snacks when childhood--- compressed biscuits are the earliest meal replacement representatives (the existence of the age of leakage). This refers specifically to bowel preparation before colonoscopy, especially for people who are old and frail and need adequate nutrition or who are often inadvertently unable to comply with dietary requirements. As a formula that has been made, meal replacement can better eliminate hunger, provide nutrients, and replenish energy sources, and is gradually used in hospital clinics.
A high-level, high-quality meal replacement study from Taiwan found that more than 200 patients were randomized to have better patient satisfaction, adherence, bowel preparation, and help reduce laxative use, which is very strong evidence of the advantages of meal replacement use. But it cannot be ignored that meal replacements also have their disadvantages, first of all, the ** of meal replacements is generally high, which directly affects the acceptance of patients; Secondly, the taste of meal replacement is often the same, and in order to increase the energy value per unit volume, the proportion of lipids is higher, and whether the taste is acceptable has become a new problem. But because of these shortcomings, the future of meal replacements has become more promising.
Intestinal polyps vs.Dietary requirements.
Diet can inhibit intestinal adenoma (a type of neoplastic polyp), and high-fiber diet and magnesium-rich dietary preparations have the effect of reducing the production of intestinal adenoma. However, there is also evidence that not restricting the diet is associated with increased complications after polypectomy. Diet and intestinal polyps love and kill each other, which makes patients after intestinal polypectomy even more confusing, and for such patients, the main concern is when and how will they be cured? During the process from the removal of intestinal polyps to the time of healing, we may experience complications such as bleeding and delayed perforation after polypectomy.
Some evidence suggests that risk factors for complications include polyp size, proximal colon, endoscopist experience, hypertension, and use of anticoagulants. Other studies have found that polyp size and the pathologic nature of the underlying malignant transformation are the most significant risk factors for complications. Of course, in these studies, the researchers did not follow a daily diet after the removal of intestinal polyps, but often used a soft diet after surgery, such as porridge and noodles, and simultaneously used drugs that inhibit gastric acid (gastric polyps), and added hemostatic drugs and drugs to promote mucosal healing if necessary; After 2-3 days, return to your daily diet as appropriate. This is a feasible, acceptable, achievable and practical solution. Of course, depending on the size and number of polyps and the intraoperative operation, the operating doctor will restrict the diet to different degrees according to different conditions, and even require fasting. Therefore, after polyp removal, it is necessary to strictly follow the doctor's instructions to carry out the precautions.
Reference: Gimeno-García Az, et al endoscopy. 2019;51(7):628-636. chou ck, et al. dis colon rectum. 2016;59(10):975-983. decosse jj, et al. j natl cancer inst. 1989 sep 6;81(17):1290-7.wark pa, et al. am j clin nutr. 2012 sep;96(3):622-31.5.huang r, et al. gastroenterol rep (oxf). 2022 apr 25;10:goac013.
This article guides the experts.
Department of Digestive Endoscopy, Li Chujun, Chief Physician.
Chief Physician, Master's Supervisor, Postdoctoral Cooperative Supervisor; Director of the Department of Digestive Endoscopy, The Sixth Affiliated Hospital of Sun Yat-sen University.
Academic positions: President of the Digestive Health Branch of Guangdong Health and Wellness Association and Consultant of the Digestive Endoscopy Committee of the Digestive Health Branch; Member of the Standing Committee of the Digestive Endoscopy Branch of the Cross-Strait Medical and Health Exchange Association; Member of the Standing Committee of the Digestive Endoscopy Branch of the Guangdong Medical Association and member of the Gastroenterology Branch; Member of the Standing Committee of the Tumor Endoscopy Professional Committee of Guangdong Anti-Cancer Association; Member of the Standing Committee of the Digestive Endoscopy Branch of Guangdong Medical Doctor Association; Member of the expert group of Guangdong Provincial Digestive Endoscopy Professional Medical Quality Control Center; Member of the expert group of Guangdong Provincial Medical Quality Control Center for Gastroenterology; Vice Chairman of the Digestive Endoscopy Committee of Guangdong Association of Integrative Traditional and Western Medicine; Academic Advisor of Macau Society of Gastroenterology and Hepatology; Focus on and be good at all kinds of digestive endoscopy diagnosis and treatment techniques.
Academic expertise: He has rich clinical experience in the diagnosis of various esophageal, stomach, intestinal and liver, gallbladder, pancreatic and other diseases. In the past 20 years, he has focused on digestive endoscopy diagnosis and minimally invasive work, and is proficient in operating gastroscopy, colonoscopy, enteroscopy, duodenoscopy, capsule endoscopy and endoscopic ultrasound endoscopy for endoscopic diagnosis and treatment, and the examinee suffers less pain. He specializes in endoscopic ultra-minimally invasive surgery without laparotomy to ** gastrointestinal polyps, gastrointestinal submucosal tumors, early gastrointestinal cancer, biliary and pancreatic duct lesions, including common bile duct stones, pancreatic head cancer, bile duct cancer, ampullary cancer, and various gastrointestinal hemorrhagic, obstructive, and stenotic lesions, including various dilation and stenting.
Visiting hours: Wednesday morning Digestive endoscopy clinic.
We would like to thank Dr. Jiachen Sun for their support of this article.
Editor in charge: Zhang Tingting.
First Instance: Dai Xi'an.
Review: Jian Wenyang, Le Yuying.
Final review: Li Wenmin.
Approved and released: Li Hanrong.
Content**: Zhongshan Sixth Hospital.