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Adding simehicone to sodium phosphate bowel preparation benefits colonscopy?

July 08, 2009

Bowel preparation has been reported inadequate in 10%-75% of colonoscopic examinations. None of the preparations reached all the requirements of safety, acceptance to patients with negligible discomfort, and rapid cleansing. Polyethyleneglycol is considered as the gold standard for colonoscopic bowel preparation (Grade IA), and aqueous sodium phosphate was an alternative regimen to PEG solution (Grade IA). This consensus also stated that adjunctive therapy, such as bisacodyl, metoclopramide, and simethicone, was shown to improve the quality of bowel preparation. Simethicone works as an adjunct to bowel preparationwith the purpose of diminishing foam formation and improving visualization during colonoscopy. However, the benefit of simethicone in improving colonic bowel preparation, however, was not explored in previous studies.

A research led by Abhasnee Sobhonslidsuk from Thailand addressed this issue. The article is to be published on June 28, 2009 in the World Journal of Gastroenterology. A prospective, double-blind, randomized, placebo-controlled study was conducted with 124 patients involved. All the patients were allocated to receive 2 doses of sodium phosphate plus 240 mg of simethicone tablet or placebo as bowel preparations. Visibility was blindly assessed for the amount of air bubbles and adequacy of colon preparation. Total colonoscopic duration, side effects of the medication, satisfaction from endoscopists and patients were also compared.

The results revealed that Sodium phosphate plus simethicone, compared to sodium phosphate plus placebo, improved visibility by diminishing air bubbles, but simethicone failed to demonstrate improvement in adequacy of colon preparation. Endoscopist and patient shared high satisfaction in the simethicone group. However, there was no difference in the total duration of colonoscopy and side effects of the medication.

This article is also of significance of exploration of colonoscopy duration and the satisfaction from the endoscopists and the patients.

World Journal of Gastroenterology

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