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

Endoscopy ◽  
2017 ◽  
Vol 50 (04) ◽  
pp. 412-422 ◽  
Author(s):  
Shenghong Zhang ◽  
Danping Zheng ◽  
Jinping Wang ◽  
Jianwei Wu ◽  
Pingguang Lei ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Conventional Group ◽  
Intubation Time ◽  
Cecal Intubation ◽  
Adenoma Detection ◽  
Bowel Cleansing ◽  
Cecal Intubation Time ◽  
Low Volume ◽  
The Right

Abstract Background and study aims For bowel preparation, using a reduced volume of polyethylene glycol (PEG) solution without influencing its effectiveness would be preferable. While simethicone shows great potential as an adjunctive agent, data on its use are limited. We aimed to clarify whether simethicone added to low-volume PEG solution improved bowel cleansing. Patients and methods Consecutive adult patients registered for colonoscopy were recruited from seven medical centers in South China between 15 April and 15 July 2015 and prospectively randomized into two groups: 2 L PEG (conventional group) and 2 L PEG plus simethicone (simethicone group). The primary endpoint was the effectiveness of bowel cleansing according to the Boston Bowel Preparation Scale (BBPS). Secondary endpoints included cecal intubation time, adenoma detection rate (ADR), patient safety and compliance, and adverse events. Results We included 290 and 289 patients in the conventional and simethicone groups, respectively, for analysis. The proportion with acceptable bowel cleansing (BBPS ≥ 6) was significantly higher in the simethicone group than in the conventional group (88.2 % vs. 76.6 %; P < 0.001). The mean (SD) BBPS score was significantly lower in the conventional group (6.5 [1.8] vs. 7.3 [1.7]; P < 0.001), as was the bubble score (2.5 [0.7] vs. 2.8 [0.5]; P < 0.001). The average cecal intubation time was significantly shorter in the simethicone group (6.3 [3.1] vs. 7.5 [5.1] minutes; P < 0.001). The ADR in the right colon was higher in the simethicone group than in the conventional group (16.6 % vs. 10.3 %; P = 0.03). Safety and compliance, including the taste, smell, and dosage of PEG, were similar for both groups. Conclusions Simethicone added to low-volume PEG solution improves bowel-cleansing efficacy, with similar safety and compliance, shorter cecal intubation time, and higher ADR.

scholarly journals Optimal Timing of Simethicone Supplement for Bowel Preparation: A Prospective Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zhen-wen Wu ◽  
Sheng-gang Zhan ◽  
Mei-feng Yang ◽  
Yi-teng Meng ◽  
Feng Xiong ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Controlled Trial ◽  
Optimal Timing ◽  
Intubation Time ◽  
Right Colon ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Cecal Intubation Time ◽  
The Right

Background and Aims. Simethicone (SIM), as an antifoaming agent, has been shown to improve bowel preparation during colonoscopy. However, the optimal timing of SIM addition remained undetermined. We aimed to investigate the optimal timing of SIM addition to polyethylene glycol (PEG) to improve bowel preparation. Methods. Eligible patients were randomly assigned to two groups: the SIM evening group (SIM addition to PEG in the evening of the day prior to colonoscopy) and the SIM morning group (SIM addition to PEG in the morning of colonoscopy). The primary outcome was Bubble Scale (BS). The secondary outcomes were Boston Bowel Preparation Scale (BBPS) and adenoma detection rate (ADR). Results. A total of 419 patients were enrolled in this study. The baseline characteristics of the patients were similar in both groups. No significant differences were observed in terms of BS (8.76 ± 0.90 vs. 8.65 ± 1.16, P  = 0.81), ADR (34.1% vs. 30.8%, P  = 0.47), Boston Bowel Preparation Scale (BBPS) (8.59 ± 0.94 vs. 8.45 ± 1.00, P  = 0.15), and withdrawal time (8.22 ± 2.04 vs. 8.01 ± 2.51, P  = 0.094) between the two groups. Moreover, safety and compliance were similar in both groups. However, the SIM evening group was associated with shorter cecal intubation time (3.80 ± 1.81 vs. 4.42 ± 2.03, P  < 0.001), higher BS (2.95 ± 0.26 vs. 2.88 ± 0.38, P  = 0.04) in the right colon, and diminutive ADR (62.5% vs. 38.6%, P  = 0.022) in the right colon, when compared to the SIM evening group. Conclusions. The SIM addition to PEG in the evening of the day prior to colonoscopy can shorten cecal intubation time and improve BS scores and diminutive ADR of the right colon compared with the SIM addition to PEG in the morning of colonoscopy in bowel preparation.

scholarly journals Oral Sulfate Solution versus Polyethylene Glycol as a Single-Day Preparation for Colonoscopy: A Randomized Control Trial

2019 ◽  
Vol 10 (03) ◽  
pp. 174-177
Author(s):  
Bhavik Bharat Shah ◽  
Bubun Patel ◽  
Mahesh Kumar Goenka
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Statistical Significance ◽  
Sulfate Solution ◽  
Cecal Intubation ◽  
Solution Versus ◽  
Bowel Cleansing ◽  
Cecal Intubation Time ◽  
Colonoscopy Preparation ◽  
To Receive

Abstract Background Colonoscopy is a principal diagnostic tool for most colonic disorders. Adequate bowel preparation is essential for proper visualization of the mucosa. The aim of this study was to compare the tolerability, efficacy, and safety profile of 1 L of oral sulfate solution (OSS) in comparison to 2 L of polyethylene glycol (PEG) solution. Methods In this single-center prospective study conducted at our institute, patients were randomly assigned to receive either OSS or PEG solutions for colonoscopy preparation. Patients enrolled in either group completed a questionnaire assessing the taste of the solution used, adverse effects, and number of stools passed. Grading of the bowel cleansing quality was done as per Boston Bowel Preparation (BBP) score. Results Total of 400 patients, with 222 patients in the PEG group and 178 patients in the OSS group, were assessed. In the PEG group, 148 (66.75%) patients were males and in the OSS group 112 (62.9%) patients were males. There was no statistical significance on comparison of the taste as “good” or “bad” in both groups. All the adverse events were mild to moderate in intensity and their frequencies were comparable for both the groups. The OSS group had better bowel preparation as per the BBP score (p = 0.021) and lesser cecal intubation time (p = 0.028). Conclusion The present study demonstrated that 1 L of OSS is better than the well-established 2 L PEG solution, in terms of bowel preparation and shorter time to cecal intubation.

Impact of sex and body mass index on cecal intubation time. Is it a myth that colonoscopy is easier to perform in obese than lean people?

10.20883/183 ◽  
2016 ◽  
Vol 85 (4) ◽  
pp. 298 ◽  
Author(s):  
Elżbieta Poniewierka ◽  
Robert Dudkowiak ◽  
Witold Marczyński
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Endoscopic Examination ◽  
Normal Weight ◽  
Intubation Time ◽  
Obese People ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Cecal Intubation Time

Introduction. Colonoscopy is the gold standard for prevention and early diagnosis of colorectal cancer. Procedure quality is an important issue. Current quality indicators, such as cecal intubation rate, adenoma detection rate, and withdrawal time, are important, but cecum intubation time influences all of them. Factors that determine cecal intubation time (CIT) include body mass index (BMI), age, sex, history of abdominal surgery, quality of bowel preparation, and visceral adipose tissue. Among those who perform colonoscopy, it is believed that the procedure is easier to perform in obese people. Aim. To determine whether cecal intubation time depends on body mass index and sex of patients undergoing colonoscopy.Material and Methods. An analysis of the technical aspects of colonoscopy, such as the time required to intubate the cecum, with respect to BMI and sex in 100 patients.Results. The average time taken to reach the cecum or ileum was slightly longer in obese people than in people with normal weight. Average CIT was almost one minute longer in men than women. Average CIT in obese men was slightly longer than in normal weight men. There was no difference in average CIT in obese and normal weight women. The differences were not statistically significant.Conclusions. This study demonstrates that the claim that endoscopic examination of the lower gastrointestinal tract is easier to perform in obese people cannot be objectively confirmed.

Tu1367 Low Volume Polyethylene Glycol Versus Magnesium Citrate As Bowel Preparation for Colonoscopy: Comparing Adenoma Detection Rates

2013 ◽  
Vol 77 (5) ◽  
pp. AB515-AB516
Author(s):  
Darwin F. Yeung ◽  
Majid Alsahafi ◽  
Fergal Donnellan ◽  
Baljinder Salh ◽  
Nazira Chatur
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Magnesium Citrate ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Low Volume

scholarly journals Recent Advances in Colonic Preparation for an Accurate Colonoscopy - How to Improve Our Practice to Meet the Quality Criteria

2020 ◽  
Vol 27 (3) ◽  
pp. 139-144
Author(s):  
Mihai-Radu PAHOMEANU ◽  
Lucian NEGREANU
Keyword(s):  
Bowel Preparation ◽  
Gastrointestinal Endoscopy ◽  
Quality Criteria ◽  
Screening Colonoscopy ◽  
Diffi Cult ◽  
Adenoma Detection ◽  
Examination Time ◽  
Bowel Cleansing ◽  
Colonic Preparation ◽  
Low Volume

Colorectal cancer (CRC) remains a major problem of global health. Screening colonoscopy is the gold standard in detection of CRC. A quality colonoscopy needs good indication, adequate bowel preparation, adequate examination time (30 to 45 minutes), a minimum 6 minutes time for mucosal examination during colonoscopy descent, a good centre adenoma detection rate. In 28-33% of the colonoscopies, the bowel preparation is unsatisfactory which leads to several hidden costs including the rise of preventable and treatable death rate regarding colorectal carcinoma. The ESGE (European Society of Gastrointestinal Endoscopy) recommends a maximum of 10% poor preparations, threshold that is diffi cult to reach in many centres. Newer low-volume laxative regimens for bowel cleansing are better in the fi elds of compliance and tolerability than the classic 4L PEG with 2L PEG-CS (Clensia ®) being one of the new promising low-volume formulas. The low fi bre diet is now preferred due to better compliance and tolerability.

Endoscopists with Longer Cecal Intubation Time than Withdrawal Time Have Lower Adenoma Detection Rate

2013 ◽  
Vol 108 ◽  
pp. S186
Author(s):  
Shailendra Singh ◽  
Elie Aoun ◽  
Vishal Goyal ◽  
Mayuri Gupta ◽  
Trupti Shinde ◽  
...  
Keyword(s):  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Intubation Time ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Cecal Intubation Time

scholarly journals Cap-assisted colonoscopy: a meta-analysis of high-quality randomized controlled trials

2018 ◽  
Vol 06 (10) ◽  
pp. E1214-E1223 ◽  
Author(s):  
Venkat Nutalapati ◽  
Vijay Kanakadandi ◽  
Madhav Desai ◽  
Mojtaba Olyaee ◽  
Amit Rastogi
Keyword(s):  
Meta Analysis ◽  
Intubation Time ◽  
Intubation Rate ◽  
High Quality ◽  
Cecal Intubation ◽  
Randomized Controlled ◽  
Adenoma Detection ◽  
Cecal Intubation Time ◽  
Cecal Intubation Rate ◽  
Standard Colonoscopy

Abstract Background and study aims Standard colonoscopy (SC) is the preferred modality for screening for colon cancer; however, it carries a significant polyp/adenoma miss rate. Cap-assisted colonoscopy (CC) has been shown to improve polyp/adenoma detection rate, decrease cecal intubation time and increase cecal intubation rate when compared to standard colonoscopy (SC). However, data on adenoma detection rate (ADR) are conflicting. The aim of this meta-analysis was to compare the performance of CC with SC for ADR among high-quality randomized controlled trials. Patients and methods We performed an extensive literature search using MEDLINE, EMBASE, Scopus, Cochrane and Web of Science databases and abstracts published at national meetings. Only comparative studies between CC and SC were included if they reported ADR, adenoma per person (APP), cecal intubation rate, and cecal intubation time. The exclusion criterion for comparing ADR was studies with Jadad score ≤ 2. The odds ratio (OR) was calculated using Mantel-Haenszel method. I2 test was used to measure heterogeneity among studies. Results Analysis of high-quality studies (Jadad score ≥ 3, total of 7 studies) showed that use of cap improved the ADR with the results being statistically significant (OR 1.18, 95 % CI 1.03 – 1.33) and detection of 0.16 (0.02 – 0.30) additional APP. The cecal intubation rate in the CC group was 96.3 % compared to 94.5 % with SC (total of 17 studies). Use of cap improved cecal intubation (OR 1.61, 95 % CI 1.33 – 1.95) when compared to SC (P value < 0.001). Use of cap decreased cecal intubation time by an average of 0.88 minutes (95 % CI 0.37 – 1.39) or 53 seconds. Conclusions Meta-analysis of high-quality studies showed that CC improved the ADR compared to SC.

scholarly journals Factors Influencing Cecal Intubation Time during Retrograde Approach Single-Balloon Enteroscopy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tzu-Ming Ou ◽  
Peng-Jen Chen ◽  
Yu-Lueng Shih ◽  
Meng-Ting Wang ◽  
Hsin-Hung Huang ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Predisposing Factors ◽  
Intubation Time ◽  
Multivariate Logistic Regression ◽  
Cecal Intubation ◽  
Factors Influencing ◽  
Cecal Intubation Time ◽  
Inadequate Bowel Preparation

Background and Aim. The predisposing factors for prolonged cecal intubation time (CIT) during colonoscopy have been well identified. However, the factors influencing CIT during retrograde SBE have not been addressed. The aim of this study was to determine the factors influencing CIT during retrograde SBE.Methods. We investigated patients who underwent retrograde SBE at a medical center from January 2011 to March 2014. The medical charts and SBE reports were reviewed. The patients’ characteristics and procedure-associated data were recorded. These data were analyzed with univariate analysis as well as multivariate logistic regression analysis to identify the possible predisposing factors.Results. We enrolled 66 patients into this study. The median CIT was 17.4 minutes. With univariate analysis, there was no statistical difference in age, sex, BMI, or history of abdominal surgery, except for bowel preparation(P=0.021). Multivariate logistic regression analysis showed that inadequate bowel preparation (odds ratio 30.2, 95% confidence interval 4.63–196.54;P<0.001) was the independent predisposing factors for prolonged CIT during retrograde SBE.Conclusions. For experienced endoscopist, inadequate bowel preparation was the independent predisposing factor for prolonged CIT during retrograde SBE.

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