Study On The Efficacy Of Simethicone In Bowel Preparation

Aim This study aimed to investigate whether simethicone added to PEG solution could increase the ADR and improve bowel cleansing for the patients undergoing colonoscopy.To provide the evidence that simethicone is an ancillary drug for bowel preparation.Methods This was a prospective,endoscopist-blinded randomized controlled trial.Consecutive adult patients registered for colonoscopy were recruited from Beijing Friendship Hospital between December 2017 to February 2018 and prospectively randomized into two groups: PEG(conventional group)and PEG plus simethicone(research group).Split-dosing the preparation had been performed.The primary outcome was ADR;secondary outcomes were quality of bowel preparation,measured by the Boston bowel preparation scale(BBPS)and bubble scores.The data was analyzed by SPSS 19.0.Results We included 204 and 202 patients in the conventional and research groups respectively,for ITT analysis.More adenomas were detected in the research group than in the conventional group(ADR: 21.5% vs.13.9%,P=0.38;advanced ADR 8.5% vs.6.3%,P=0.38).The mean number of adenomas detected was 2.20±1.36 vs.1.63±0.89(P=0.02).The proportion with acceptable bowel cleansing(BBPS?6)was significantly higher in the research group than in the conventional group(85.7% vs.73.4%;P<0.001).Patients in the research group showed better bowel cleansing efficacy: BBPS?6 in 88.3% vs.76.2%(P<0.001),BBPS?8 in 55.7% vs.33.4%(P<0.001)and bubble scores of 1.00±1.26 vs.3.98±2.50(P<0.001).Abdominal bloating was reported less frequently in the research group(12.3% vs.19.8 %;P=0.005)than in the research group.Conclusion Combined use of PEG and simethicone is associated with a significantly increased ADR,reduced bowel foam,improved bowel cleansing efficacy.