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- Title
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
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>In total, 240 patients were randomly allocated to the three groups; six patients were withdrawn.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).<bold>Conclusion: </bold>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.
- Subjects
BOWEL preparation (Procedure); POLYETHYLENE glycol; VITAMIN C; COLONOSCOPY; ANTIFOAMING agents
- Publication
Digestive Diseases & Sciences, 2019, Vol 64, Issue 9, p2607
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-019-05599-2