Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population

• Published in: Endoscopy International Open 2021-02, Vol.9 (2), p.E190-E194
• Main Authors: Manfredi, Guido, Bertè, Roberto, Iiritano, Elena, Alicante, Saverio, Londoni, Claudio, Brambilla, Giancarlo, Romeo, Samanta, Menozzi, Fernanda, Griffanti, Paola, Brandi, Giovanna, Moreschi, Oliva, Pezzilli, Raffaele, Zullo, Angelo, Buscarini, Elisabetta
• Format: Article
• Language: English
• Subjects: Original article
• ISSN: 2364-3722; 2196-9736
• DOI: 10.1055/a-1315-0114

Abstract Background and study aim  Pre-endoscopic use of a preparation with tensioactive and mucolytic agents improved gastric mucosa visualization in Eastern studies. Data on Western population are scanty. Patients and methods  This prospective, endoscopist-blinded, randomized study enrolled patients who underwent esophagogastroduodenoscopy in a single center. Before endoscopy patients, were randomized to receive or not receive an oral preparation with simethicone and N-acetylcysteine in water. A pretested score (Crema Stomach Cleaning Score [CSCS]) for gastric mucosa cleaning evaluation was used. In detail, the stomach was divided into the antrum, body, and fundus and a score of 1 to 3 was assigned to each part (the higher the score, the better the preparation), and a total value ≤ 5 was considered as insufficient. Time between endoscope insertion and clean achievement (mouth to clean time) or the end of examination (mouth to mouth time) was recorded. Results  A total of 197 patients were enrolled. The mean overall CSCS value and mucosal cleaning in all parts was better in treated patients than in controls. Prevalence total score ≤ 5 was significantly lower in patients treated before endoscopy. Need for water flush occurred less frequently in treated patients ( P