Randomized, double-blinded, placebo-controlled trial evaluating simethicone pretreatment with bowel preparation during colonoscopy
Loading...
Authors
Rishi, Mohit
Kaur, Jaskarin
Ulanja, Mark B.
Manasewitsch, Nicholas
Svendsen, Molly
Abdalla, Abubaker O.
Vemala, Shashank
Kewanyama, Julie
Singh, Karmjit
Singh, Nirmal
Issue Date
2019
Type
Article
Language
Keywords
Adenoma detection , Colonoscopy , Intraluminal bubbles , Simethicone
Alternative Title
Abstract
The presence of small air bubbles and foam are an impediment to a successful colonoscopy. They impair an endoscopist's view and diminish the diagnostic accuracy of the study. This has been particularly noted to be of concern with the switch to lower volume polyethylene glycol (PEG) and bisacodyl combination preparation. AIM To evaluate the effect of oral simethicone addition to bowel preparation on intraluminal bubbles reduction during colonoscopy. METHODS: Described is a prospective, randomized, multi-center, double-blinded, placebo-controlled study to evaluate the use of premixed simethicone formulation with split-regimen, low-volume PEG-bisacodyl combination bowel preparation for 168 outpatients undergoing screening, surveillance, and diagnostic colonoscopies. Primary outcome includes evaluation of bubbles during colonoscopy graded using the Intraluminal Bubbles Scale. Secondary outcomes include evaluation of the Boston Bowel Preparation Scale (BBPS), total number of polyps, polyp size differentiation, polyp laterality, adenoma detection, mass detection, cecal insertion time, withdrawal time, and patient-reported adverse events. RESULTS Higher Intraluminal Bubbles grades III and IV (less than 75% of the mucosa cleared of bubbles/foam requiring intervention with simethicone infused wash) were detected in the placebo group [Simethicone n = 4/84 vs Placebo n = 20/84 (P = 0.007)]. BBPS total score was 7.42 [standard deviation (SD) = +/- 1.51] in the simethicone group and 7.28 (SD = +/- 1.44) in the placebo group (P = 0.542) from a total of 9. Significantly higher number of adenomas were detected in the simethicone group (P = 0.001). CONCLUSION The addition of simethicone to bowel preparation is well advised for its anti-foaming properties. The results of this study suggest that addition of oral simethicone can improve bowel wall visibility.
Description
Citation
Rishi, M., Kaur, J., Ulanja, M., Manasewitsch, N., Svendsen, M., Abdalla, A., … Osgard, E. (2019). Randomized, double-blinded, placebo-controlled trial evaluating simethicone pretreatment with bowel preparation during colonoscopy. World Journal of Gastrointestinal Endoscopy, 11(6), 413�"423. doi:10.4253/wjge.v11.i6.413
Publisher
License
Creative Commons Attribution-NonCommercial 4.0 International
Journal
Volume
Issue
PubMed ID
ISSN
1948-5190