title: Effect of hyoscine N-butylbromide on adenoma detection rate: meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  Anti-spasmodic drugs may facilitate mucosal inspection during colonoscopy. The impact of hyoscine N-butylbromide (HBB) on polyp detection rate (PDR) and adenoma detection rate (ADR) is unclear.
  
  
  METHODS
  We conducted a reproducible literature search of multiple databases. Two reviewers independently compared manuscripts for PDR, ADR, advanced adenoma detection rate (AADR), and rates of complications. Pooling was conducted by fixed-effects and random-effects models. Relative risk (RR) estimates were calculated (95% confidence interval). I(2) index assessed heterogeneity.
  
  
  RESULTS
  Patient demographics were comparable. The pooled analysis showed a trend toward improving PDR and ADR among the HBB group compared with the placebo group but failed to reach statistical significance, (46% vs 43%, RR = 1.08 [0.94, 1.25], P = 0.27), (31% vs 28%, RR = 1.12 [0.97, 1.29], P = 0.11) respectively.
  
  
  CONCLUSIONS
  HBB during colonoscopy may provide marginal improvements in ADR and PDR. However, heterogeneity in the available data precludes firm conclusions at this time.
authors.affiliation: Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, USA; Veteran Affairs Medical Center, Oklahoma City, USA.
authors.forename: Mohammad F
authors.initials: MF
authors.lastname: Madhoun
authors.forename: Tauseef
authors.initials: T
authors.lastname: Ali
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
authors.forename: John T
authors.initials: JT
authors.lastname: Maple
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D002086:Butylscopolammonium Bromide; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015994:Incidence; D008297:Male; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D002086:Butylscopolammonium Bromide
keywords: adenoma detection rate; antispasmodic; colonoscopy; hyoscine N-butylbromide; polyp detection rate