Efficacy of low‐dose versus high‐dose simethicone with polyethylene glycol for bowel preparation: A prospective randomized controlled trial

Li, De‐feng; Luo, Ming‐Han; Du, Qingqing; Zhang, Haiyang; Tian, Yingying; Liu, Ting‐ting; Shi, Rui-Yue; Xiong, Feng; Lai, Mingguang; Li, Ying-xue; Luo, Su; Yang, Song; Wu, Ben-Hua; Xu, Zefeng; Zhang, Dingguo; Yao, Jun; Wang, Lisheng

doi:10.1111/jgh.15022

Cited by 9 publications

(16 citation statements)

References 38 publications

(70 reference statements)

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“…In the subgroup analysis, we compared the effect of low-dose simethicone (< 400 mg) to that of high-dose simethicone (≥ 400 mg) for the ADR and PDR. Our results revealed that simethicone at a high or low dose made no significant difference in terms of ADR and PDR, suggesting that the low dose was not inferior to the high dose, similar to the study of Li et al [ 45 ]. Further research is required to determine the optimal dose of simethicone in clinical practice.…”

Section: Discussionsupporting

confidence: 91%

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis

Gong

et al. 2021

WJCC

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BACKGROUND Although several trials have shown that the addition of antifoaming agents to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agents have a beneficial role in the detection of benign tumors during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors. AIM To clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors. METHODS The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps. RESULT Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group taking simethicone. We also found that simethicone could significantly improve the ADR in the proximal colon but did not affect the colorectal polyp detection rate. Furthermore, the subgroup analyses revealed a beneficial effect of simethicone on the ADR among Asians ( P = 0.005) and those with an ADR < 25% ( P = 0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of benign colorectal tumors. CONCLUSION In summary, the addition of simethicone to PEG might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

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Section: Discussionsupporting

confidence: 91%

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis

Gong

et al. 2021

WJCC

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“…In the subgroup analysis, we compared the effect of the low dose simethicone (< 400 mg) versus that of high dose simethicone (≥ 400 mg) for ADR and PDR. Our results also revealed that simethicone with high or low dose had no signi cant difference of ADR and PDR, suggesting that the low-dose simethicone was not inferior to the high-dose one in terms of ADR and PDR, which is similar to the study of Li et al [39]. Although residual simethicone in biopsy channels could promote bio lm formation [40], simethicone adding to PEG solution could decrease the infection risk of endoscope-transmission [31].However, the optimal dose of SIM is yet to be ascertained [41].…”

Section: Discussionsupporting

confidence: 91%

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Zhang¹,

Liu²,

Ls³

2020

Preprint

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Background: Although several trials have showed that addition of antifoaming agent to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agent has a beneficial role in detection of benign tumours during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the effect of detection of colorectal benign tumours.Methods: The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.Results: Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group with simethicone. We also found that simethicone could significantly improve the ADR in proximal colon, but did not affect the colorectal polyp detection rate (PDR). Furthermore, the subgroup analyses revealed that the beneficial effect of simethicone in the ADR among Asian (P=0.005) and ADR < 25% (P =0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of colorectal benign tumours.Conclusions: In summary, the addition of simethicone to PEG might benefit to improve diminutive adenomas in the right colon for colonoscopy in Asia. The low-dose simethicone was recommend to the detection of colorectal benign tumours. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

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“…Bowel preparation was administered as previously described [12]. In the SIM evening group, the patients were instructed to consume 200 mg SIM (Berlin-Chemie AG, Berlin, Germany) in addition to 1L PEG (Shenzhen Wan he Pharmaceutical Co. Ltd, Shenzhen, China) at 7 PM on the day prior to colonoscopy, and the remaining 1L PEG was ingested in the morning 5 hours before colonoscopy.…”

Section: Bowel Preparationmentioning

confidence: 99%

“…Moreover, several studies have reported that simethicone (SIM), as an antifoaming agent, combined with PEG for bowel preparation can improve bowel preparation quality and patients' tolerance [10,11]. Meanwhile, we discovered that the addition of low-dose SIM (200 mg) to split-dose 2L PEG was as effective as the addition of high-dose SIM (1200 mg) with respect to adequate bowel preparation, ADR, and patients' tolerance in a Chinese population [12]. However, the optimal time of simethicone addition to PEG for bowel preparation remains undetermined.…”

Section: Introductionmentioning

confidence: 99%

Optimal Timing of Simethicone Supplement for Bowel Preparation: A Prospective Randomized Controlled Trial

Zhan

Yang

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims. Simethicone (SIM), as an antifoaming agent, has been shown to improve bowel preparation during colonoscopy. However, the optimal timing of SIM addition remained undetermined. We aimed to investigate the optimal timing of SIM addition to polyethylene glycol (PEG) to improve bowel preparation. Methods. Eligible patients were randomly assigned to two groups: the SIM evening group (SIM addition to PEG in the evening of the day prior to colonoscopy) and the SIM morning group (SIM addition to PEG in the morning of colonoscopy). The primary outcome was Bubble Scale (BS). The secondary outcomes were Boston Bowel Preparation Scale (BBPS) and adenoma detection rate (ADR). Results. A total of 419 patients were enrolled in this study. The baseline characteristics of the patients were similar in both groups. No significant differences were observed in terms of BS (8.76 ± 0.90 vs. 8.65 ± 1.16, P = 0.81), ADR (34.1% vs. 30.8%, P = 0.47), Boston Bowel Preparation Scale (BBPS) (8.59 ± 0.94 vs. 8.45 ± 1.00, P = 0.15), and withdrawal time (8.22 ± 2.04 vs. 8.01 ± 2.51, P = 0.094) between the two groups. Moreover, safety and compliance were similar in both groups. However, the SIM evening group was associated with shorter cecal intubation time (3.80 ± 1.81 vs. 4.42 ± 2.03, P < 0.001), higher BS (2.95 ± 0.26 vs. 2.88 ± 0.38, P = 0.04) in the right colon, and diminutive ADR (62.5% vs. 38.6%, P = 0.022) in the right colon, when compared to the SIM evening group. Conclusions. The SIM addition to PEG in the evening of the day prior to colonoscopy can shorten cecal intubation time and improve BS scores and diminutive ADR of the right colon compared with the SIM addition to PEG in the morning of colonoscopy in bowel preparation.

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Efficacy of low‐dose versus high‐dose simethicone with polyethylene glycol for bowel preparation: A prospective randomized controlled trial

Cited by 9 publications

References 38 publications

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis

Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

Optimal Timing of Simethicone Supplement for Bowel Preparation: A Prospective Randomized Controlled Trial

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