Effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility: A single blinded, placebo control, randomized trial

Abstract

Objective: To determine effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility.
 Methods: A randomized, single blinded placebo control trial was done in patients undergoing oesophago-gastro-duodenoscopy for any indication at DOTs Endoscopy Suite, CHK during the period of April to June 2019. Informed consent was taken. Patients were randomly allocated in two groups. Group-A received placebo while Group-B received Simethicone. Evaluation of mucosal visibility was assessed at 4 sites (oesophagus, fundus, antrum & duodenum) by previously validated scoring. Mean of visibility scores were compared in two groups.
 Results: Two hundred and forty-eight patients were inducted and randomly allocate to two groups of 124 each. Mean of total sum of scores in Group-A was 8.14 ±2.44 and that of Group-B was 5.80 ±1.75 (p<0.001). Adequate visibility in Group-A was seen in 41.1% and that in Group-B was 78.2% (p<0.001).Conclusion: Use of Simethicone significantly improves mucosal visibility during OGD.
 doi: https://doi.org/10.12669/pjms.36.2.1241
 How to cite this:Zuberi BF, Shaikh MA, Ali FS, Rasheed T, Nawaz Z. Effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility: A single blinded, placebo control, randomized trial. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1241
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Minimizing the Risks of Simethicone in Endoscope Reprocessing

“…5,6,36 Another 4 randomized trials supporting the use of simethicone pre-gastroscopy have been published after these meta-analyses. [42][43][44][45] European guidelines recommend adding simethicone to bowel prep before colonoscopy 46,47 Two meta-analyses found simethicone added to the bowel prep improved mucosal visibility and bowel cleanliness. 30,31 Three RCTs found simethicone increased the adenoma detection rate.…”

“…Three meta-analyses support the use of simethicone given orally before gastroscopy showing that simethicone improves mucosal visibility and increases lesion detection 5,6,36. Another 4 randomized trials supporting the use of simethicone pre-gastroscopy have been published after these meta-analyses 42–45…”