Simethicone improves bowel cleansing with low-volume polyethylene glycol: a multicenter randomized trial

Zhang, Shenghong; Zheng, Danping; Wang, Jinping; Wu, Jianwei; Lei, Pingguang; Luo, Qi; Wang, Liping; Zhang, Beiping; Wang, Hong; Chen, Yi; Chen, Minhu

doi:10.1055/s-0043-121337

Cited by 46 publications

(100 citation statements)

References 35 publications

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“…The result of meta‐analysis of ADR is in accordance with results of studies conducted by Bai et al . and Zhang et al ,. which confirmed that supplemental SIM added to PEG significantly increased ADR during colonoscopy, but it is inconsistent with the results of the other four trials, in which supplemental orally‐administrated SIM was not related to a significant increase in ADR.…”

Section: Discussionsupporting

confidence: 89%

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

Pan

Zhao

et al. 2018

J of Gastro and Hepatol

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Section: Discussionsupporting

confidence: 89%

“…In order to improve the level of bowel cleansing, simethicone (SIM), a kind of oral antifoaming agent, has been added to several PEG‐based bowel preparation regimens, for it reduces bubbles in bowel segments so as to improve visualization of the colonic mucosa and promote emission of excessive gas …”

Section: Introductionmentioning

confidence: 99%

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

Pan

Zhao

et al. 2018

J of Gastro and Hepatol

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“…Our search strategy identified 535 potentially relevant records after excluding duplicates. After careful review, 36 studies that met inclusion criteria were further evaluated for eligibility, and 12 full‐text articles from 2009 to 2017 were included in this meta‐analysis . The review process is illustrated by a flowchart of Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Participants in most studies included adults who underwent colonoscopy for routine clinical indications such as testing positive for occult stool blood, but in three studies, the populations were restricted to those with a positive fecal immunochemical test or chronic constipation . Among these studies, seven (58.3%) were from Europe, four were from Asia, and one was from the USA; four of the studies were multicenter trials . Intention‐to‐treat analysis was stated in eight studies, whereas three studies used per‐protocol analysis, and in one study, the information was lacking .…”

Section: Resultsmentioning

confidence: 99%

“…One meta‐analysis showed that oral simethicone helps reduce bubbles and improves visibility in upper gastrointestinal endoscopy, but the ADR was not evaluated because few studies had addressed this issue at the time it was published. Several subsequent randomized controlled trials evaluated the bowel cleansing effects of adjuvant simethicone; however, whether it had a beneficial role in ADR or polyp detection rate (PDR) had yet to be confirmed …”

Section: Introductionmentioning

confidence: 99%

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The benefit of adding oral simethicone in bowel preparation regimen for the detection of colon adenoma: A systematic review and meta‐analysis

Yeh

Hsu

Tseng

et al. 2018

J of Gastro and Hepatol

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Background and Aim Simethicone is an anti‐foaming agent commonly used during colonoscopy. Although several randomized trials have shown that oral simethicone in the bowel preparation regimen may improve bowel cleanness, whether it improves adenoma detection rate (ADR) or polyp detection rate remains undetermined. The aim of this study was to determine if oral simethicone in bowel preparation regimen before colonoscopy improves the ADR. Methods A comprehensive literature review was conducted using PubMed, SDOL, Cochrane Library, and ProQuest databases through December 2017. Randomized controlled trials that compared bowel preparation regimens with simethicone versus those without it were included. Effect estimates from each study were extracted and underwent meta‐analysis using appropriate models. The primary outcomes were ADR and polyp detection rate, and secondary outcomes included bowel preparation, bubble score, and withdrawal time. Results Twelve published randomized controlled studies with 6003 participants were included for meta‐analysis. There was no difference in the overall ADR (pooled risk ratio = 1.06, 95% confidence interval = 0.91–1.24) and right‐side ADR (risk ratio = 1.50, 95% confidence interval = 0.82–2.75) between the groups with or without simethicone. However, the addition of simethicone improved adenoma detected per patient (2.20 ± 1.36 vs 1.63 ± 0.89) according to one of the included studies. Meta‐regression revealed that the baseline ADR < 25% of the included studies was associated with significant benefit of oral simethicone; the number needed to treat was 15. Conclusions The adjunction of oral simethicone significantly improved bowel preparation quality and might benefit adenoma detection in specific settings with low baseline ADR.

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Oral simethicone tablets with PEG‐ELS split‐prep reduces frequency of inadequate bowel cleansing and decreases bubbles

et al. 2021

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Background: Intraluminal bubbles may prevent the visualisation of mucosa during a colonoscopy. Simethicone minimises bubbles, but its impact on incomplete bowel preparation and optimal protocols for use are unclear. Aim:To assess the impact of oral simethicone tablets when added to 2-litre, splitprep, polyethylene glycol electrolyte lavage solution + ascorbic acid on bubble score and frequency of incomplete bowel preparation.Methods: This QA/QI project assessed outpatients who underwent colonoscopy at the Veterans Affairs Ann Arbor Healthcare System. After endoscopists were trained in intraluminal bubble scoring systems, data about bubble score, frequency of inadequate bowel preparation requiring early repeat colonoscopy, quality of bowel preparation using Boston Bowel Preparation Scale (BBPS), and patient tolerance were collected before and after addition of oral simethicone 160mg to each dose of 2-litre split-prep.Results: There were no differences in patient characteristics between the baseline group (n = 348) and the simethicone group (n = 354). Simethicone improved the total mean intraluminal bubble score from 8.18 to 8.78 (P < 0.001). Early repeat colonoscopy due to inadequate bowel preparation was higher in the baseline group vs simethicone group: 8.7% vs 4.6%, P = 0.03 with an RRR = 0.5 (95% CI 0.26-0.95).Using BBPS, the frequency of having inadequate cleansing in any colon segment was higher in the baseline group vs simethicone group: 6.6% vs 3.1%; RRR = 0.55 (95% CI 0.21-0.94). | 255 MARATT eT Al. How to cite this article: Maratt JK, Freeman AE, Schoenfeld P, et al. Oral simethicone tablets with PEG-ELS split-prep reduces frequency of inadequate bowel cleansing and decreases

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Simethicone improves bowel cleansing with low-volume polyethylene glycol: a multicenter randomized trial

Abstract: Simethicone added to low-volume PEG solution improves bowel-cleansing efficacy, with similar safety and compliance, shorter cecal intubation time, and higher ADR.

Cited by 46 publications

References 35 publications

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

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

The benefit of adding oral simethicone in bowel preparation regimen for the detection of colon adenoma: A systematic review and meta‐analysis

Oral simethicone tablets with PEG‐ELS split‐prep reduces frequency of inadequate bowel cleansing and decreases bubbles

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