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Cited 27 time in webofscience Cited 28 time in scopus
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Improving of bowel cleansing effect for polyethylene glycol with ascorbic acid using simethicone A randomized controlled trial

Authors
Yoo, In KyungJeen, Yoon TaeKang, Seung HunLee, Jae HyungKim, Seung HanLee, Jae MinChoi, Hyuk SoonKim, Eun SunKeum, BoraChun, Hoon JaiLee, Hong SikKim, Chang Duck
Issue Date
Jul-2016
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
ascorbic acid; bowel preparation; colonoscopy; polyethylene glycol; simethicone
Citation
MEDICINE, v.95, no.28
Indexed
SCI
SCIE
SCOPUS
Journal Title
MEDICINE
Volume
95
Number
28
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/6272
DOI
10.1097/MD.0000000000004163
ISSN
0025-7974
1536-5964
Abstract
Background and Aim: Low-volume polyethylene glycol with ascorbic acid (PEG-Asc) use is reported to be as safe and effective as traditional 4-L polyethylene glycol use. However, PEG-Asc produces bubbles, which cause problems during colonoscopy. Data on the effects of using antifoaming agents such as simethicone with PEG-Asc are lacking. The aim of this CONSORT-prospective, randomized, observer-blinded, controlled trial is to compare the quality of bowel preparation and compliance between PEG-Asc users and PEG-Asc plus simethicone users. Methods: Adult outpatients aged 18 to 80 years undergoing colonoscopy were recruited to the study. Two hundred sixty patients were randomly assigned to 1 of 2 treatment arms, PEG-Asc or PEG-Asc plus simethicone. The primary outcome measure was the bowel cleansing quality using Boston bowel preparation scale and bubble scores. The secondary outcome measures were patient tolerability and doctor tolerability. Results: The simethicone group showed superior cleansing results (6-9 Boston scale scores: 99% vs. 84%, <5% bubble scores: 96% vs. 49%, P<0.001) and fewer gastrointestinal symptoms (abdominal fullness: 24% vs. 55%, colicky pain: 5% vs. 24%, P<0.001) than the non-simethicone group. Moreover, endoscopist fatigue during colonoscopy was lower in the simethicone group than in the non-simethicone group (1.31 +/- 0.75 vs. 2.97 +/- 2.14, P<0.001). Conclusion: PEG-Asc plus simethicone use was more effective and associated with better patient and endoscopist tolerance than PEG-Asc use. Therefore, this combination is recommended as one of the promising methods for bowel preparation before colonoscopy.
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Jeen, Yoon Tae
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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