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Published on: August 1, 2019
The Efficacy of Simethicone With Polyethylene Glycol for Bowel Preparation: A Systematic Review and Meta-Analysis
Background:
Simethicone (SIM) is a commonly used antifoaming agent in the clinic. However, it has not been clarified whether SIM can improve the quality of intestinal preparation and the detection rates of adenomas (ADR) and polyps (PDR). This systematic review and meta-analysis were carried out to mainly evaluate the effect of SIM in bowel preparation for colonoscopy.
Materials And Methods:
An electronic and a manual search of the literature for studies was conducted in PubMed, EMBASE, and Web of Science in all published data before February 1, 2020. The primary outcomes were the quality of bowel preparation and the ADR and PDR. All the data were calculated using a pooled estimate of risk ratio with 95% confidence intervals, and a random-effect model was used for the calculation.
Results:
Eighteen randomized controlled trials with 7187 patients were included in this meta-analysis. Polyethylene glycol (PEG) with SIM improved colon cleansing (P<0.00001), PDR (P=0.006) and the detection rate of lesions in the right colon (P<0.00001) when compared with PEG alone. There was no difference in the ADR (P=0.68), withdrawal time (P=0.06), cecal intubation rate (P=0.98), and cecal intubation time (P=0.65) between 2 groups. The rate of abdominal bloating rate was higher in the PEG group, but there was no significant difference in vomiting (P=0.65), and abdominal pain (P=0.25).
Conclusions:
SIM improves the quality of bowel cleanliness and PDR but not ADR. Besides, SIM improves the detection rate of lesions in the right colon and decreased abdominal bloating, but do not affect vomiting and abdominal pain or cramping.
Insights
Simethicone (SIM) improves bowel preparation quality and polyp detection rates during colonoscopy. However, it does not significantly increase adenoma detection rates (ADR) or affect other procedural metrics.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Medical Research
Background:
- Simethicone (SIM) is a common antifoaming agent.
- Its efficacy in improving colonoscopy bowel preparation and adenoma detection rates (ADR) remains unclear.
Purpose of the Study:
- To evaluate the effect of SIM on bowel preparation quality for colonoscopy.
- To assess the impact of SIM on adenoma detection rates (ADR) and polyp detection rates (PDR).
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched PubMed, EMBASE, and Web of Science for studies published before February 1, 2020.
- Analyzed primary outcomes including bowel preparation quality, ADR, and PDR using risk ratios and confidence intervals.
Main Results:
- Eighteen trials with 7187 patients were included.
- Polyethylene glycol (PEG) with SIM significantly improved colon cleansing (P<0.00001) and PDR (P=0.006) compared to PEG alone.
- No significant difference was observed in ADR (P=0.68), withdrawal time, or cecal intubation rates.
Conclusions:
- SIM enhances bowel cleanliness and polyp detection rates (PDR).
- SIM does not improve adenoma detection rates (ADR).
- SIM reduces abdominal bloating without affecting vomiting or abdominal pain.
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