Dietary restriction after cold snare polypectomy of colorectal polyp for prevention of delayed bleeding

Abstract

Abstract Background and Aim Cold snare polypectomy (CSP) for small colorectal polyps is a safe technique; however, there is little evidence on whether dietary restriction after CSP is essential. This study aimed to determine whether dietary restriction after CSP is necessary to prevent delayed bleeding. Methods This is a randomized, controlled, non‐inferiority trial conducted between November 2021 and March 2022. Patients with non‐pedunculated small colorectal polyps (<10 mm) and who did not take anticoagulants were randomly allocated to two groups: (i) the normal diet (ND) group, and (ii) the low‐residue diet (LRD) group. The ND group was instructed to eat anything after CSP, whereas the LRD group was advised to take LRD for 3 days after CSP. The primary endpoint was the occurrence of delayed major bleeding that needed endoscopic hemostasis. Results A total of 193 patients (average 57.5 years old, 51.9% male) were enrolled in the study. Subsequently, 97 and 96 patients were allocated to the ND and LRD group, respectively. The occurrence of delayed major bleeding was 1.0% in the ND group and 2.1% in the LRD group (95% confidence interval [CI]: −4.4% to 2.4%; difference: −1.1%), which showed the non‐inferiority of the ND group. In addition, there was no difference between the two groups with respect to the occurrence of minor delayed bleeding (3.1% and 4.2%, respectively; difference: −1.1% [95% CI: −6.4% to 4.2%]). Conclusion Dietary restriction after CSP for low‐bleeding‐risk colorectal polyps is not necessary for the prevention of delayed bleeding (Registration number: UMIN000045669).

Keywords

• adenoma
• cold snare polypectomy
• colonoscopy
• colorectal polyp
• dietary restriction