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Simethicone adjunct to polyethylene glycol improves small bowel capsule endoscopy imaging in non-Crohn's disease patients.

Papamichael K, Karatzas P, Theodoropoulos I, Kyriakos N, Archavlis E, Mantzaris GJ - Ann Gastroenterol (2015 Oct-Dec)

Bottom Line: Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064).Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD.Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Evaggelismos Hospital, Athens, Greece.

ABSTRACT

Background: Currently, there is no standardized protocol for bowel preparation before small bowel capsule endoscopy (SBCE). This study aimed to investigate the effect of simethicone combined with polyethylene glycol (PEG) on the visualization quality (VQ) of the SBCE in patients with or without known or suspected Crohn's disease (CD).

Methods: This observational, prospective, single-center study included consecutive patients undergoing a SBCE between 2007 and 2008. Patients received either a standard bowel cleansing preparation of 2 L PEG and 80 mg simethicone orally 12 and 1 h before SBCE respectively (Group A) or only PEG (Group B). VQ, based on scores for luminal bubbles in frames taken from the small intestine, examination completeness, SBCE diagnostic yield, gastric and small bowel transit times were recorded.

Results: Of the 115 patients finally included (Group A, n=56 and Group B, n=59) the cecum was visualized in 103 (89.6%). Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064). Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD.

Conclusion: Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients.

No MeSH data available.


Related in: MedlinePlus

Small bowel capsule endoscopy visualization quality based on a 4-scale grading system regarding both the proximal (A) and the distal (B) bowel
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Figure 1: Small bowel capsule endoscopy visualization quality based on a 4-scale grading system regarding both the proximal (A) and the distal (B) bowel

Mentions: Simethicone overall improved the VQ in the proximal bowel segment [OR: 2.43 (95%CI: 1.08-5.45), P=0.032], but not in the distal segment, although a trend was observed (P=0.064) (Fig. 1, Table 2). Subgroup analysis showed that the addition of simethicone had no effect on the VQ of patients undergoing SBCE either for known CD or suspected (and eventually confirmed) CD (P=0.507); however, simethicone premedication improved significantly the VQ in the proximal bowel segment in non-CD patients [OR: 2.93 (95%CI: 1.06-8.08), P=0.047] (Table 2).


Simethicone adjunct to polyethylene glycol improves small bowel capsule endoscopy imaging in non-Crohn's disease patients.

Papamichael K, Karatzas P, Theodoropoulos I, Kyriakos N, Archavlis E, Mantzaris GJ - Ann Gastroenterol (2015 Oct-Dec)

Small bowel capsule endoscopy visualization quality based on a 4-scale grading system regarding both the proximal (A) and the distal (B) bowel
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585393&req=5

Figure 1: Small bowel capsule endoscopy visualization quality based on a 4-scale grading system regarding both the proximal (A) and the distal (B) bowel
Mentions: Simethicone overall improved the VQ in the proximal bowel segment [OR: 2.43 (95%CI: 1.08-5.45), P=0.032], but not in the distal segment, although a trend was observed (P=0.064) (Fig. 1, Table 2). Subgroup analysis showed that the addition of simethicone had no effect on the VQ of patients undergoing SBCE either for known CD or suspected (and eventually confirmed) CD (P=0.507); however, simethicone premedication improved significantly the VQ in the proximal bowel segment in non-CD patients [OR: 2.93 (95%CI: 1.06-8.08), P=0.047] (Table 2).

Bottom Line: Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064).Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD.Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Evaggelismos Hospital, Athens, Greece.

ABSTRACT

Background: Currently, there is no standardized protocol for bowel preparation before small bowel capsule endoscopy (SBCE). This study aimed to investigate the effect of simethicone combined with polyethylene glycol (PEG) on the visualization quality (VQ) of the SBCE in patients with or without known or suspected Crohn's disease (CD).

Methods: This observational, prospective, single-center study included consecutive patients undergoing a SBCE between 2007 and 2008. Patients received either a standard bowel cleansing preparation of 2 L PEG and 80 mg simethicone orally 12 and 1 h before SBCE respectively (Group A) or only PEG (Group B). VQ, based on scores for luminal bubbles in frames taken from the small intestine, examination completeness, SBCE diagnostic yield, gastric and small bowel transit times were recorded.

Results: Of the 115 patients finally included (Group A, n=56 and Group B, n=59) the cecum was visualized in 103 (89.6%). Simethicone overall improved the VQ in the proximal [OR: 2.43 (95%CI: 1.08-5.45), P=0.032] but not in the distal bowel segment (P=0.064). Nevertheless, this effect was not observed in patients undergoing SBCE for either known or suspected CD.

Conclusion: Simethicone as an adjunct to PEG for bowel preparation in patients undergoing SBCE significantly improved the VQ in non-CD patients.

No MeSH data available.


Related in: MedlinePlus