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The effect on colon visualization during colonoscopy of the addition of simethicone to polyethylene glycol-electrolyte solution: a randomized single-blind study.
MedLine Citation:
PMID:  23238113     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Rebecca Matro; Keegan Tupchong; Constantine Daskalakis; Victoria Gordon; Leo Katz; David Kastenberg
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Publication Detail:
Type:  Journal Article     Date:  2012-11-29
Journal Detail:
Title:  Clinical and translational gastroenterology     Volume:  3     ISSN:  2155-384X     ISO Abbreviation:  Clin Transl Gastroenterol     Publication Date:  2012  
Date Detail:
Created Date:  2012-12-14     Completed Date:  2012-12-17     Revised Date:  2012-12-17    
Medline Journal Info:
Nlm Unique ID:  101532142     Medline TA:  Clin Transl Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e26     Citation Subset:  -    
Affiliation:
Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA, USA.
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