Optimal Timing of Simethicone Addition for Bowel Preparation Using Polyethylene Glycol Plus Ascorbic Acid
- Authors
- Kim, Haewon; Ko, Bong Min; Goong, Hyeon Jeong; Jung, Yun Ho; Jeon, Seong Ran; Kim, Hyun Gun; Lee, Moon Sung
- Issue Date
- Sep-2019
- Publisher
- Kluwer Academic/Plenum Publishers
- Keywords
- Simethicone; Bowel preparation; ADR; PEG
- Citation
- Digestive Diseases and Sciences, v.64, no.9, pp 2607 - 2613
- Pages
- 7
- Journal Title
- Digestive Diseases and Sciences
- Volume
- 64
- Number
- 9
- Start Page
- 2607
- End Page
- 2613
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4277
- DOI
- 10.1007/s10620-019-05599-2
- ISSN
- 0163-2116
1573-2568
- Abstract
- Background Colonic bubbles obscure the colonic mucosa during colonoscopy following bowel preparation with polyethylene glycol plus ascorbic acid (PEG-Asc). Simethicone is used to enhance visualization during colonoscopy. We aimed to determine the optimal timing of simethicone addition to improve bowel preparation using PEG-Asc. Methods This prospective, randomized study enrolled patients undergoing elective colonoscopy from April 2017 to January 2018. They were randomly assigned to one of the following three groups: PEG-Asc only (control) or simethicone addition in the morning on the day of colonoscopy (PEG-S1) or in the evening of the day prior to colonoscopy (PEG-S2). The primary outcome was the quality of colon cleansing, and the secondary outcomes were the adenoma detection rate (ADR), polyp detection rate (PDR), and diminutive (<= 5 mm) ADR. Results In total, 240 patients were randomly allocated to the three groups; six patients were withdrawn. Of the 234 patients evaluated, 78, 79, and 77 were allocated to the control, PEG-S1, and PEG-S2 groups, respectively. The bubble scores of all colonic segments were lowest in the PEG-S2 group. There was no significant difference in ADR or PDR among the three groups. However, the diminutive ADR was significantly higher in the PEG-S2 group compared to the other two groups (control 5.1% vs. PEG-S1 8.9% vs. PEG-S2 20.8%; P = 0.009). Conclusion Addition of simethicone to PEG-Asc at the optimal time prevents the formation of air bubbles and so improves the quality of bowel preparation, especially enhancing diminutive ADR.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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