Impact of polyethylene glycol plus simethicone on intraluminal bubble score during colonoscopy: A randomized endoscopist blinded trial

• Author Details:   
• Vinoth Kumar
• Kalaiselvi B
• Nandini R
• Dutta Trayambak
• Ezhil Arasan R ^*

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Introduction and Aim: Colonic air bubbles and foam are major hurdle to a positive colonoscopy. Bubbles hinder mucosal visibility resulting in poor diagnostic precision. This study aimed to determine the efficacy and tolerability of Simethicone in reducing the occurrence of colonic bubbles that could interfere with colon visualization, when added to Polyethylene glycol bowel preparation regimen.
Materials and Methods: This is a prospective randomized observer blind interventional study comparing PEG vs PEG + simethicone. Adult outpatients aged 18 to 60 years undergoing colonoscopy were recruited in this study. The primary outcome was the reduction in bubbles measured by intraluminal bubble score. The secondary outcome measures were patients’ tolerability and endoscopists ease.
Results: The incidence of Score 1 and 2 bubbles was much lower with PEG + simethicone compared with PEG group (P<.0001). Bubble scores in the control vs study group were significantly different in various segments of the colon. Of the 150 Segments of colon caecum, ascending colon, transverse colon, descending colon and rectosimoid examined segments without bubbles in the control vs study group (38.4% vs 88% P<0>
Conclusion: PEG plus simethicone was more effective in reducing bubbles and enhances the mucosal visualization during colonoscopy.

Keywords: Simethicone, Polyethylene glycol, Colonoscopy, Intraluminal bubbles, Bowel preparation.