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- Title
Vitamin C Solution Spray Can Replace Sodium Thiosulfate Solution Spray to Completely Neutralize Iodine Staining and Substantially Relieve the Mucosal Irritation Caused by Lugol Chromoendoscopy: A Multicenter, Randomized, Double-Blind, Parallel Trial.
- Authors
Duochen Jin; Guoxin Zhang
- Abstract
Background/Aims Lugol chromoendoscopy facilitates the endoscopic visualization of esophageal dysplasia and carcinoma. Vitamin C solution (VCS) can theoretically neutralize free iodine, which causes mucosal irritation. Aim was to assess the safety and efficacy of VCS for relieving adverse symptoms caused by Lugol's iodine staining. Methods Two hundred forty eligible subjects were randomized to receive 20 mL of normal saline (NS), 5% sodium thiosulfate solution (STS) or 2% VCS after spraying 10 mL of 2% Lugol's iodine solution on the mid-distal esophagus. The primary endpoints were statistically significant reductions in the acute and late adverse symptom severity scores. The secondary endpoint was the discoloration effect on esophageal brown iodine-stained mucosa. Results Spraying both VCS and STS similarly decreased the severity scores of the acute [NS vs VCS: 2.58 vs 1.61, p=0.040; VCS vs STS: 1.61 vs 1.89, p>0.999] and late [NS vs VCS: 1.70 vs 0.91, p=0.002; VCS vs STS: 0.91 vs 1.38, p=0.212] adverse symptoms after Lugol chromoendoscopy compared with spraying NS. Compared with STS spray, VCS spray remarkably alleviated acute acid regurgitation or heartburn (33% vs 15%, p=0.017) and late retrosternal discomfort or pain (21% vs 9%, p=0.027). Moreover, compared with spraying NS, spraying VCS quickly discolored the iodine-stained mucosa, with a better decolorization score (2.26 vs 3.56, p=0.000), which was similar to the effects of spraying STS (3.56 vs 3.59, p=0.908). Conclusions VCS can reduce the mucosal irritation symptoms induced by Lugol chromoendoscopy and can be routinely recommended.
- Subjects
VITAMIN C; IODINE; SPRAYING; THIOSULFATES; HEARTBURN; BARRETT'S esophagus; NEUTRALIZATION tests
- Publication
Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p31
- ISSN
1976-2283
- Publication type
Article