title: Effectiveness of premedication with pronase for improving visibility during gastroendoscopy: a randomized controlled trial.
abstract: BACKGROUND
  Minute early gastric cancers can be removed with endoscopic mucosal resection techniques. However, early detection of these minute cancers with endoscopy is still difficult. For this purpose, use of a dye is helpful. To increase visibility further, gastric mucus should be removed before endoscopic examination. In this study, the effectiveness of premedication with pronase for improving visibility during gastroendoscopy was investigated.
  
  
  METHODS
  From January through July 1996, outpatients scheduled for gastroendoscopy were randomly assigned to oral premedication with the antifoam agent dimethylpolysiloxane alone (n=34), with dimethylpolysiloxane plus sodium bicarbonate (n=32), or with dimethylpolysiloxane, sodium bicarbonate, and pronase (n=34). All were given about 10 minutes before the start of endoscopy. After inserting the endoscope, the endoscopist gave visibility scores at conventional endoscopy and after methylene blue spraying.
  
  
  RESULTS
  Premedication with pronase significantly improved visibility before and after methylene blue spraying as compared with the two other groups pretreated without pronase. Pronase also significantly shortened the times for chromoendoscopic examination. Pronase had no significant effect on the culture of Helicobacter pylori.
  
  
  CONCLUSIONS
  Premedication with pronase improved endoscopic visualization during conventional endoscopy and chromoendoscopy. Its routine use at gastroendoscopy is therefore recommended.
authors.affiliation: Department of Nursing, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujii
authors.forename: H
authors.initials: H
authors.lastname: Iishi
authors.forename: M
authors.initials: M
authors.lastname: Tatsuta
authors.forename: R
authors.initials: R
authors.lastname: Hirasawa
authors.forename: N
authors.initials: N
authors.lastname: Uedo
authors.forename: K
authors.initials: K
authors.lastname: Hifumi
authors.forename: M
authors.initials: M
authors.lastname: Omori
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004129:Dimethylpolysiloxanes; D005260:Female; D005756:Gastritis / Q000175:diagnosis; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011292:Premedication; D011402:Pronase; D012680:Sensitivity and Specificity; D017693:Sodium Bicarbonate; D013274:Stomach Neoplasms / Q000175:diagnosis; D013276:Stomach Ulcer / Q000175:diagnosis
chemical_list: D004129:Dimethylpolysiloxanes; D017693:Sodium Bicarbonate; D011402:Pronase; D008751:Methylene Blue