Abstract
Objective:To determine effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility.Methodology:A randomized, single blinded placebo control trial was done in patients undergoing oesophago-gastro-duodenoscopy for any indication at DOTs Endoscopy Suite, CHK during the period of April to June 2019. Informed consent was taken. Patients were randomly allocated in two groups. Group-A received placebo while Group-B received Simethicone. Evaluation of mucosal visibility was assessed at 4 sites (oesophagus, fundus, antrum & duodenum) by previously validated scoring. Mean of visibility scores were compared in two groups.Results:Two hundred and forty-eight patients were inducted and randomly allocate to two groups of 124 each. Mean of total sum of scores in Group-A was 8.14 ±2.44 and that of Group-B was 5.80 ±1.75 (p<0.001). Adequate visibility in Group-A was seen in 41.1% and that in Group-B was 78.2% (p<0.001).Conclusion:Use of Simethicone significantly improves mucosal visibility during OGD.
Highlights
Oesophago-gastro-duodenoscopy (OGD) plays a crucial in diagnosis of upper GI disorders, and great importance lies in early detection of mucosal lesions for timely diagnosing and treating the hazardous diseases including malignancies
Group-A was given 50 ml of placebo while Group-B was given 15 ml Simethicone (Infacol) syrup diluted in 35 ml of water for ingestion 10 minutes before endoscopy (Fig.1)
This study demonstrates improved mucosal visualization on OGD after Simethicone
Summary
Oesophago-gastro-duodenoscopy (OGD) plays a crucial in diagnosis of upper GI disorders, and great importance lies in early detection of mucosal lesions for timely diagnosing and treating the hazardous diseases including malignancies. Presence of intraluminal bubbles and foams hamper mucosal visibility, which may cause missing of subtle mucosal lesions[1,2] and increasing operator’s time of performing OGD. It has been reported that up to 13% of malignancies are missed in index OGD that are subsequently diagnosed in repeat procedure or other investigations.[7,8] In presence of high definition endoscopic system, it is important that preparation should be extremely good to have proper visualization. Despite the effect of simethicone on mucosal visibility its use in OGD is not existent in practice. There is dire need to establish its efficacy in OGD in a properly conducted trial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
