Addition Of Simethicone To Polyethylene Glycol Electrolyte Solution For Bowel Preparation Improves Colonoscopic Bowel Visualization

Background:The only effective way to properly visualize the entire colon is via colonoscopy. For optimum high quality colonoscopy, effective bowel preparation is an absolute requirement, as an incomplete colonoscopy can reduce the likelihood of detecting adenomas or polyps. It can also increase the duration of the procedure, negatively influence the patient’s tolerability and the performing doctor’s satisfaction. Additionally, it can cause a higher risk of complications. The most common limitation a physician can encounter during a routine colonoscopy is the presence of air bubbles that can affect a proper visualization of the entire colon. Prior to a colonoscopy, physicians routinely use a variety of laxatives for bowel preparation. All of them have unique positive and negative qualities.Objectives:The aim of this study was to evaluate the effect of Simethicone when it is combined with polyethylene glycol whereby the amount of colonic bubbles, endoscopist satisfaction, patient’s tolerability and duration of a colonoscopy procedure is reduced.Methods:this was a prospective, single center study comparing 3L polyethylene glycol electrolyte solution (PEG-ELS) to PEG with simethicone 30ml (PEG+S), both administered it as a split dose, in patients undergoing elective outpatient and inpatient colonoscopy in gastroenterology unit.Results:Hundred patients enrolled,50patients in each group, there was no statistical significant between the two groups in terms of age, sex and major procedure indications. In grading of bubbles, total of 31 (62%) patients in PEG+S group had grade A bubbles compare to 11 (22%) of patients in control group; in grade B bubbles 16 (32%) patients of experimental group and 25 (50%) patients in control group scored respectively; total of 3(6%) patients of experimental group and 14(28%) patients in control group had grade C bubbles, and shows a statistical significance (P value<0.001,Z=4.821). flushingwas significantly less in the PEG+S group (P=0.001, Z=3.804). Endoscopist satisfaction was higher in simethicone group with (P value< 0.0001, Z=4.094).No statistically significant differences were found in total procedure time, the occurrence of adverse drug reactions, patient’s tolerability and acceptability.Conclusion:Adding simethicone to PEG-ELS efficiently remove bubbles, significantly reduces the need for flushing, and results in more superb preparations...