When should patients take simethicone orally before colonoscopy for avoiding bubbles: A single-blind, randomized...

Area of Science:

• Gastroenterology
• Endoscopy

Background:

• Simethicone is frequently used to reduce bubbles during colonoscopy, but its benefit and optimal timing are debated.
• Current guidelines offer weak recommendations for simethicone use before colonoscopy.

Purpose of the Study:

• To confirm the advantages of simethicone administration for colonoscopy.
• To determine the optimal timing for simethicone administration to improve colonoscopy efficacy.

Main Methods:

• A randomized controlled trial involving 204 patients assigned to five groups based on simethicone administration timing (day before vs. day of, before vs. after bowel cleansing, and control).
• Key outcomes measured included bubble score (BS), number of irrigations needed, endoscopist satisfaction, and insertion time.

Main Results:

• Simethicone administration timing significantly impacted bubble scores (P < .001).
• Administering simethicone on the day of the examination resulted in significantly better bubble scores compared to the day before or the control group (P < .001).
• The day-of-examination group also showed fewer irrigations and higher endoscopist satisfaction (P < .001).

Conclusions:

• Simethicone effectively reduces bubbles and enhances colonoscopy effectiveness, particularly when administered on the day of the procedure.
• Optimal simethicone administration for improved colonoscopy outcomes is on the examination day, irrespective of bowel preparation timing.