Evaluation of Oral Simethicone With Low Volume Polyethylene Glycol Bowel Preparation During Colonoscopy
Status:
Completed
Trial end date:
2018-10-31
Target enrollment:
Participant gender:
Summary
An adequate bowel preparation has been well established to lead to a successful colonoscopy.
Research has consistently demonstrated inadequate bowel preparation with lower adenoma
detection rates. Over the years, endoscopy centers have changed the constituents of bowel
preparation in light of new research. In 2006, 3 medical organizations recommended the use of
polyethylene glycol (PEG) solution for bowel preparation. Initially, a 4 liter PEG solution
was commonly used using a split dose regimen for bowel prep. However, many patients found
that this large volume gave them side effects including bloating and cramping. Other studies
showed that a low volume PEG solution with oral bisacodyl fared equally in terms of adequacy
of bowel preparation. With the institution of lower volume PEG preparation our offices noted
improved patient toleration, satisfaction, and clinical outcomes. However, multiple
endoscopists have noticed an increased in intraluminal bubbles and foam with the low volume
preparation. This can impair proper visualization of the bowel wall even with an adequate
bowel preparation. The current standard of practice includes irrigation, lavage, and
suctioning using a simethicone infused saline during the colonoscopy. Its property of
reducing surface tension to help dissolve bubbles and clear the field of view is vital during
the procedure. Furthermore, it does not dissolve into the blood stream and thereby, is
considered rather safe.
This study evaluates whether the addition of oral simethicone with the colonoscopy bowel
preparation reduces bubbles and foam during the procedure using a randomized and controlled
interventional study.