Title: Low-residue diet with oral nutritional supplements prior to colonoscopy improves the
quality of bowel preparation: an endoscopist-blinded, randomized controlled trial
Version: 0 Date: 06 Jan 2025
Reviewer's report:
1. The introduction regarding the use of the oral nutritional supplement may require some
clarification. Currently, there is a lack of a clear explanation of how the supplement functions
and the underlying hypotheses supporting its use. More detailed information on these aspects
would enhance understanding and potentially strengthen the overall presentation.
2. For sample size calculation, the authors referred to the study that did not involve any specific
regimen in the diet modification or nutritional supplement.
3. Patient selection should emphasize on the patients with prior experience of colonoscopy.
4. How can the authors ensure that participants comply with the low residual diet and take the
ONS? How much of the PEG was consumed in each patient?
5. When was the grading of bowel preparation evaluated,  whether during the scope withdrawal
or evaluation from the still images afterward?
6. The use of intraluminal simethicone might help to decrease the gas bubble or improve the
visualization. The authors should mention whether simethicone was used or not.
7. Clarification on the evaluation of bowel preparation is of the utmost importance in this study.
The authors should explain how vigorously water irrigation during withdrawal is used to clean
and suction the residue.
8. The fasting time from the last dose of PEG and the time of colonoscopy affect the preparation
quality.  Data regarding the fasting time should be presented.
9. The withdrawal time also impacts the evaluation of bowel preparation quality. How did the
authors balance the time used in cleaning the colon between the two groups.
Title: Low-residue diet with oral nutritional supplements prior to colonoscopy improves the
quality of bowel preparation: an endoscopist-blinded, randomized controlled trial
Version: 0 Date: 06 Jan 2025
Reviewer's report:
1. The introduction regarding the use of the oral nutritional supplement may require some
clarification. Currently, there is a lack of a clear explanation of how the supplement functions
and the underlying hypotheses supporting its use. More detailed information on these aspects
would enhance understanding and potentially strengthen the overall presentation.
2. For sample size calculation, the authors referred to the study that did not involve any specific
regimen in the diet modification or nutritional supplement.
3. Patient selection should emphasize on the patients with prior experience of colonoscopy.
4. How can the authors ensure that participants comply with the low residual diet and take the
ONS? How much of the PEG was consumed in each patient?
5. When was the grading of bowel preparation evaluated,  whether during the scope withdrawal
or evaluation from the still images afterward?
6. The use of intraluminal simethicone might help to decrease the gas bubble or improve the
visualization. The authors should mention whether simethicone was used or not.
7. Clarification on the evaluation of bowel preparation is of the utmost importance in this study.
The authors should explain how vigorously water irrigation during withdrawal is used to clean
and suction the residue.
8. The fasting time from the last dose of PEG and the time of colonoscopy affect the preparation
quality.  Data regarding the fasting time should be presented.
9. The withdrawal time also impacts the evaluation of bowel preparation quality. How did the
authors balance the time used in cleaning the colon between the two groups.
Please review this paper.
user
Title: Low-residue diet with oral nutritional supplements prior to colonoscopy improves the
quality of bowel preparation: an endoscopist-blinded, randomized controlled trial
Version: 0 Date: 06 Jan 2025
Reviewer's report:
1. The introduction regarding the use of the oral nutritional supplement may require some
clarification. Currently, there is a lack of a clear explanation of how the supplement functions
and the underlying hypotheses supporting its use. More detailed information on these aspects
would enhance understanding and potentially strengthen the overall presentation.
2. For sample size calculation, the authors referred to the study that did not involve any specific
regimen in the diet modification or nutritional supplement.
3. Patient selection should emphasize on the patients with prior experience of colonoscopy.
4. How can the authors ensure that participants comply with the low residual diet and take the
ONS? How much of the PEG was consumed in each patient?
5. When was the grading of bowel preparation evaluated,  whether during the scope withdrawal
or evaluation from the still images afterward?
6. The use of intraluminal simethicone might help to decrease the gas bubble or improve the
visualization. The authors should mention whether simethicone was used or not.
7. Clarification on the evaluation of bowel preparation is of the utmost importance in this study.
The authors should explain how vigorously water irrigation during withdrawal is used to clean
and suction the residue.
8. The fasting time from the last dose of PEG and the time of colonoscopy affect the preparation
quality.  Data regarding the fasting time should be presented.
9. The withdrawal time also impacts the evaluation of bowel preparation quality. How did the
authors balance the time used in cleaning the colon between the two groups.
assistant