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Administration of mucolytic solution before upper endoscopy - double-blind, monocentric, randomized study.

Michal Stepan1,2, Premysl Falt2, Barbora Pipek1,2,3

  • 1Digestive Diseases Center, Vitkovice Hospital, Ostrava, Czech Republic.

Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
|June 23, 2021
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A mucolytic solution did not improve mucosal visibility during upper endoscopy in this study. This finding suggests that pre-endoscopy administration of N-acetylcysteine and simethicone does not enhance diagnostic accuracy for gastrointestinal lesions.

Keywords:
N-acetylcysteinemucolytic solutionsimethiconupper endoscopyvisibility score

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Area of Science:

  • Gastroenterology
  • Endoscopic procedures
  • Diagnostic imaging

Background:

  • Optimal mucosal visualization is critical for detecting early neoplastic lesions during upper endoscopy.
  • Limited European data exist on the efficacy of mucolytic solutions to improve visibility.
  • This study addresses the need for evidence regarding mucolytic solution use prior to gastroscopy.

Purpose of the Study:

  • To evaluate the impact of a specific mucolytic solution on mucosal visibility in the upper gastrointestinal tract.
  • To assess whether N-acetylcysteine and simethicone improve endoscopic visualization compared to placebo or water alone.

Main Methods:

  • A monocentric, double-blind, randomized study involving 134 patients undergoing upper endoscopy.
  • Three arms: mucolytic solution (N-acetylcysteine + simethicone), no solution, or pure water.
  • Mucosal visibility was scored by blinded endoscopists based on photographs from defined areas.

Main Results:

  • No significant difference in mucosal visibility scores was observed between the mucolytic solution, water, and no-solution groups (P=0.32).
  • Examination times and residual gastric fluid volumes were comparable across all study arms.
  • The administration of the mucolytic solution did not lead to improved endoscopic visualization.

Conclusions:

  • The tested mucolytic solution, containing N-acetylcysteine and simethicone, did not enhance mucosal visibility in the esophagus, stomach, or duodenum.
  • These findings indicate that this specific mucolytic preparation does not offer a benefit for improving endoscopic visualization in routine upper gastrointestinal examinations.