The role of liquid simethicone in enhancing endoscopic visibility prior to esophagogastroduodenoscopy (EGD): A prospective, randomized, double-blinded, placebo-controlled trial.
BACKGROUND
Simethicone improves endoscopic visibility and diagnostic accuracy during colonoscopy and capsule endoscopy. Nevertheless, there have been limited data on its usefulness in esophagogastroduodenoscopy (EGD).


OBJECTIVE
To evaluate the effectiveness of simethicone on enhancing endoscopic visibility in patients undergoing EGD.


METHODS
121 patients were randomized to take 2 ml ofeither liquid simethicone or placebo in 60 ml of water at 15-30 minutes before EGD. The severity scores of foam and bubbles at the esophagus, stomach and duodenum were compared.


RESULTS
Simethicone improved endoscopic visibility by diminishing mean cumulative (6.83 +/- 2.4 vs. 11.05 +/- 2.6, p < 0.001) and local scores offoam and bubbles at all areas, and decreased the number and timing ofadjunctive simethicone washing (17.5% vs. 74.1%, p < 0.001 and 0 vs. 19 seconds, p < 0.001). Simethicone increased endoscopist and patient satisfaction significantly without having adverse effects.


CONCLUSIONS
Using simethicone before EGD enhances endoscopic visibility, reduces adjunctive simethicone washing and increases endoscopist and patient satisfaction.
Keeratichananont
Suriya
S
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Sobhonslidsuk
Abhasnee
A
Kitiyakara
Taya
T
Achalanan
Narin
N
Soonthornpun
Supamai
S
D000328:Adult; D000368:Aged; D000934:Antifoaming Agents / Q000008:administration & dosage*; D053705:Capsule Endoscopes; D004311:Double-Blind Method; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012841:Simethicone / Q000008:administration & dosage*; D007507:Therapeutic Irrigation / Q000379:methods*
D000934:Antifoaming Agents; D012841:Simethicone