Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

doi:10.3748/wjg.15.3032

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jun 28, 2009; 15(24): 3032-3037
Published online Jun 28, 2009. doi: 10.3748/wjg.15.3032

Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation

Sasinee Tongprasert, Abhasnee Sobhonslidsuk, Sasivimol Rattanasiri

Sasinee Tongprasert, Abhasnee Sobhonslidsuk, Division of Gastroenterology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand

Sasivimol Rattanasiri, Clinical Epidemiological Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand

Author contributions: Sobhonslidsuk A, Tongprasert S, Rattanasiri S designed the research, analyzed and interpreted the data; Tongprasert S, Sobhonslidsuk A drafted the article; Tongprasert S, Sobhonslidsuk A, Rattanasiri S wrote and revised the paper.

Correspondence to: Abhasnee Sobhonslidsuk, MD, Division of Gastroenterology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, 270 Praram 6 road, Rajathevee, Bangkok 10400, Thailand. teasb@mahidol.ac.th

Telephone: +66-2-2011304

Fax: +66-2-2011387

Received: March 18, 2009
Revised: May 22, 2009
Accepted: May 29, 2009
Published online: June 28, 2009

Abstract

AIM: To evaluate the effectiveness of simethicone in enhancing visibility and efficacy during colonoscopy.

METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted. One hundred and twenty-four patients were allocated to receive 2 doses of sodium phosphate plus 240 mg of tablet simethicone or placebo as bowel preparation. Visibility was blindly assessed for the amount of air bubbles and adequacy of colon preparation. Total colonoscopic time, side effects of the medication, endoscopist and patient satisfaction were also compared.

RESULTS: Sodium phosphate plus simethicone, compared to sodium phosphate plus placebo, improved visibility by diminishing air bubbles (100.00% vs 42.37%, P < 0.0001) but simethicone failed to demonstrate improvement in adequacy of colon preparation (90.16% vs 81.36%, P = 0.17). Endoscopist and patient satisfaction were increased significantly in the simethicone group. However, there was no difference in the total duration of colonoscopy and side effects of the medication.

CONCLUSION: The addition of simethicone is of benefit for colonoscopic bowel preparation by diminishing air bubbles, which results in enhanced visibility. Endoscopist and patient satisfaction is also increased.

Keywords: Simethicone; Colonoscopy; Bowel preparation