The effectiveness of simethicone in improving visibility during colonoscopy when given with a sodium phosphate solution: A double-blind randomized study

• Published in: Gastrointestinal endoscopy 1995-11, Vol.42 (5), p.413-415
• Main Authors: Sudduth, Robert H., DeAngelis, Sofia, Sherman, Kenneth E., McNally, Peter R.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Investigative techniques, diagnostic techniques (general aspects); Medical sciences
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(95)70041-2

Background: Oral sodium phosphate solution is better tolerated than polyethylene glycol when used for colonoscopy preparation, but visibility of the lumen can be impaired because of the presence of bubbles. Methods: We studied 86 patients receiving either simethicone (n = 42) or placebo (n = 44) in addition to oral sodium phosphate to determine if simethicone improved visibility during colonoscopy. Patients were randomized to receive 160 mg of simethicone or a placebo with 45 ml of sodium phosphate the evening before and the morning of colonoscopy. Colonoscopy was performed by a single blinded investigator. Five areas of the colon (rectosigmoid, descending, transverse, ascending, and cecum) were assessed for the presence of bubbles on withdrawal of the endoscope. Bubbles were scored as follows: 0, minimal or none; 1, covering half the lumen; 2, covering the entire circumference; 3, filling the entire lumen. Results: Thirteen patients in the placebo group and only one in the simethicone had significant bubbles (≥ 1). Additionally, the mean bubble scores were greater in the placebo group in each region of the colon ( p ≤ 0.05 in rectosigmoid and ascending colon). Conclusions: This study indicates that taking simethicone with an oral sodium phosphate preparation can improve colonic visibility by diminishing the presence of bubbles. Better visualization could improve detection of mucosal pathologic lesions. (Gastrointest Endosc 1995;42:413-5.)