Endoscopy 2018; 50(04): 412-422
DOI: 10.1055/s-0043-121337
Original article
© Georg Thieme Verlag KG Stuttgart · New York

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

Shenghong Zhang*
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
,
Danping Zheng*
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
,
Jinping Wang
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
,
Jianwei Wu
Division of Gastroenterology, The Eighth Hospital of Shenzhen, Shenzhen, PR China
,
Pingguang Lei
Division of Gastroenterology, Shenzhen Bao'an District Songgang People's Hospital, Shenzhen, PR China
,
Qi Luo
Division of Endoscopy, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, PR China
,
Liping Wang
Division of Gastroenterology, The Second People’s Hospital of Foshan, Foshan, PR China
,
Beiping Zhang
Division of Gastroenterology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, PR China
,
Hong Wang
Division of Gastroenterology, The First People’s Hospital of Guangzhou, Guangzhou, PR China
,
Yi Cui
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
,
Minhu Chen
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China
› Author Affiliations
TRIAL REGISTRATION: International Standard Randomized Controlled Trials ChiCTR-IPR-15006181 at http://www.chictr.org.cn.
Further Information

Publication History

submitted 14 March 2017

accepted after revision 12 September 2017

Publication Date:
13 November 2017 (eFirst)

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.

* These authors contributed equally to the work


Table e3, e5