The effect on colon visualization during colonoscopy of the addition of simethicone to polyethylene glycol-electrolyte solution: a randomized single-blind study.

Authors

Rebecca Matro, Thomas Jefferson University HospitalsFollow
Keegan Tupchong, Thomas Jefferson University
Constantine Daskalakis, Thomas Jefferson UniversityFollow
Victoria Gordon, Yale University
Leo Katz, Thomas Jefferson UniversityFollow
David Kastenberg, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

1-1-2012

Comments

This article has been peer reviewed. It was published in: Clinical and translational gastroenterology

2012 Nov 29;3:e26

The published version is available at DOI:10.1038/ctg.2012.16. Copyright © Nature

Abstract

OBJECTIVES: Colonic bubbles associated with polyethylene glycol-electrolyte solution (PEG-ELS) are common and obscure mucosal visualization. This study aimed to determine whether adding simethicone decreases the incidence of bubbles.

METHODS: Prospective, single-blind, randomized comparison of split dose PEG-ELS vs. PEG-ELS+simethicone (PEG-S) for outpatient colonoscopy. Bubble severity for colonic segments was assessed on withdrawal as A=no/minimal bubbles, B=moderate bubbles/interfere with detecting 5 mm polyp, C=severe bubbles/interfere with detecting 10 mm polyp. Primary end point was Grade B or C bubbles in any colon segment. Secondary end points were cleansing quality, incidence and severity of side effects, and polyp detection.

RESULTS: One hundred and thirty nine patients enrolled; 13 withdrew before colonoscopy. Of 123 patients evaluated, 62 took PEG-S and 61 PEG-ELS. The incidence of grade B or C bubbles was much lower with PEG-S compared with PEG-ELS (2% vs. 38%; P=0.001). Overall cleansing (excellent or good) quality was not significantly different for either the whole colon (89% PEG-ELS, 94% of PEG-S, P=0.529) or right colon (88% PEG-ELS, 94% PEG-S, P=0.365). More PEG-S patients had excellent rather than good preps (whole colon 53% vs. 28%, P=0.004; right colon 53% vs. 35%, P=0.044). Need for any flushing was less with PEG-S (38% vs. 70%, P=0.001). The groups were not significantly different with respect to total procedure and withdrawal times, incidence or severity of side effects, or number of polyps/patient or adenomas/patient.

CONCLUSIONS: Adding simethicone to PEG-ELS effectively eliminates bubbles, substantially reduces the need for flushing, and results in more excellent preparations.

Recommended Citation

Matro, Rebecca; Tupchong, Keegan; Daskalakis, Constantine; Gordon, Victoria; Katz, Leo; and Kastenberg, David, "The effect on colon visualization during colonoscopy of the addition of simethicone to polyethylene glycol-electrolyte solution: a randomized single-blind study." (2012). Division of Gastroenterology and Hepatology Faculty Papers. Paper 20.
https://jdc.jefferson.edu/gastro_hepfp/20

PubMed ID

23238113