Efforts to increase image quality during endoscopy: The role of pronase

Area of Science:

• Gastroenterology
• Endoscopic Imaging
• Pharmacology

Background:

• Clear visualization of the gastrointestinal mucosa is crucial for accurate endoscopic assessment.
• Mucus, foam, and bubbles frequently obstruct visibility, necessitating additional procedures like washing and suction.
• These obstructions can prolong endoscopy duration and potentially affect diagnostic quality.

Purpose of the Study:

• To evaluate the efficacy of pronase premedication in improving mucosal visibility during endoscopy.
• To assess the impact of pronase on diagnostic accuracy, particularly for Helicobacter pylori identification.
• To explore the benefits of pronase in advanced endoscopic techniques and biopsy quality.

Main Methods:

• Administration of pronase (a mixture of proteolytic enzymes) as premedication 10-20 minutes prior to endoscopy.
• Assessment of mucosal visibility in various parts of the stomach.
• Evaluation of pronase effects on chromoendoscopy, narrow-band imaging, magnifying endoscopy, and endoscopic ultrasonography.
• Analysis of potential improvements in biopsy quantity and quality.

Main Results:

• Pronase premedication significantly enhanced mucosal visibility, though effects varied by stomach location.
• Pronase did not compromise the accuracy of Helicobacter pylori identification.
• The benefits of pronase extended to advanced imaging modalities and showed potential for improved biopsy outcomes.

Conclusions:

• Pronase premedication is an effective method for improving gastrointestinal mucosal visualization during endoscopy.
• This improved visibility may aid in the detection of early-stage cancers.
• Pronase offers a valuable adjunct for various endoscopic procedures, potentially improving diagnostic yield and efficiency.