Effect of supplemental simethicone for bowel preparation on adenoma detection during colonoscopy: A meta‐analysis of randomized controlled trials

Pan, Peng; Zhao, Shengbing; Li, Bing-Han; Meng, Qianqian; Yao, Jun; Wang, Dong; Li, Zhao‐Shen

doi:10.1111/jgh.14401

Cited by 25 publications

(36 citation statements)

References 24 publications

(82 reference statements)

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“…In another study conducted in United States, addition of 480 mg SIM to 4 L PEG was not found to improve ADR; however, it reduced foam production and helped decrease the intraprocedural use of SIM . A meta‐analysis also concluded that SIM helps improve the quality of bowel preparation, ADR and patient tolerability …”

Section: Discussionmentioning

confidence: 99%

“…Simethicone (SIM) is an antifoaming agent, which helps reduce the formation of bubbles and improve bowel visibility; therefore, it is recommended as an important adjunct for bowel preparation prior to colonoscopy . Moreover, most studies have shown that use of SIM can help improve bowel preparation efficacy, shorten the cecal intubation time and increase the ADR . In a few studies, use of SIM did not help improve the ADR or reduce the procedure time; however, it is still recommended for bowel preparation as it reduces the need for intraprocedural use of SIM and decreases the risk of endoscope‐transmitted infection …”

Section: Introductionmentioning

confidence: 99%

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

Luo

et al. 2020

J of Gastro and Hepatol

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Li-sheng Wang and Jun Yao were responsible for design of the study and reviewed the manuscript. De-Feng Li, Ming-han Luo and Feng Xiong drafted the manuscript. Qing-qing Du, Hai-yang Zhang, Ting-ting Liu and Rui-yue Shi recorded the data. Ming-guang Lai, Ying-xue Li, Yan-hui Tian, Ben-hua Wu and Su Luo performed the data analysis. De-feng Li, Yang Song, Zheng-lei Xu and Ding-guo Zhang performed colonoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Luo

et al. 2020

J of Gastro and Hepatol

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“…Although simethicone adding to PEG solution could improve bowel cleanness and mucosal visibility [35], out results found that simethicone did not the affect the total ADR and PDR. It may be related to the possible explanation that solid stool was unlikely to be cleaned, despite simethicone could improve the overall bowel cleanness.…”

Section: Discussionmentioning

confidence: 82%

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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“…A meta-analysis by Yeh et al[27] evaluated 12 randomized controlled trials with a total number of 6003 patients and concluded no significant difference in ADR when simethicone was used, although sub group analysis revealed a difference in populations with low baseline ADRs. On the contrary, meta-analysis performed by Pan et al[28] showed supplemental simethicone improved ADR for colonoscopy. Discordant findings in the literature are likely attributed to limiting factors including varying bowel preparations and inconsistent blinding amongst the studies analyzed.…”

Section: Discussionmentioning

confidence: 97%

Randomized, double-blinded, placebo-controlled trial evaluating simethicone pretreatment with bowel preparation during colonoscopy

Rishi¹,

Kaur²,

Ulanja³

et al. 2019

WJGE

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BACKGROUND The presence of small air bubbles and foam are an impediment to a successful colonoscopy. They impair an endoscopist’s view and diminish the diagnostic accuracy of the study. This has been particularly noted to be of concern with the switch to lower volume polyethylene glycol (PEG) and bisacodyl combination preparation. AIM To evaluate the effect of oral simethicone addition to bowel preparation on intraluminal bubbles reduction during colonoscopy. METHODS Described is a prospective, randomized, multi-center, double-blinded, placebo-controlled study to evaluate the use of premixed simethicone formulation with split-regimen, low-volume PEG-bisacodyl combination bowel preparation for 168 outpatients undergoing screening, surveillance, and diagnostic colonoscopies. Primary outcome includes evaluation of bubbles during colonoscopy graded using the Intraluminal Bubbles Scale. Secondary outcomes include evaluation of the Boston Bowel Preparation Scale (BBPS), total number of polyps, polyp size differentiation, polyp laterality, adenoma detection, mass detection, cecal insertion time, withdrawal time, and patient-reported adverse events. RESULTS Higher Intraluminal Bubbles grades III and IV (less than 75% of the mucosa cleared of bubbles/foam requiring intervention with simethicone infused wash) were detected in the placebo group [Simethicone n = 4/84 vs Placebo n = 20/84 ( P = 0.007)]. BBPS total score was 7.42 [standard deviation (SD) = ± 1.51] in the simethicone group and 7.28 (SD = ± 1.44) in the placebo group ( P = 0.542) from a total of 9. Significantly higher number of adenomas were detected in the simethicone group ( P = 0.001). CONCLUSION The addition of simethicone to bowel preparation is well advised for its anti-foaming properties. The results of this study suggest that addition of oral simethicone can improve bowel wall visibility.

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Effect of supplemental simethicone for bowel preparation on adenoma detection during colonoscopy: A meta‐analysis of randomized controlled trials

Abstract: Supplemental SIM for bowel preparation based on polyethylene glycol is useful to improve the ADR during colonoscopy.

Cited by 25 publications

References 24 publications

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

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

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

Randomized, double-blinded, placebo-controlled trial evaluating simethicone pretreatment with bowel preparation during colonoscopy

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