The Role of Liquid Simethicone in Enhancing Endoscopic Visibility Prior to Esophagogastroduodenoscopy (EGD): A Prospective, Randomized, Double-Blinded, Placebo-Controlled Trial
Suriya Keeratichananont MD*, Abhasnee Sobhonslidsuk MD*, Taya Kitiyakara MD*, Narin Achalanan MD*, Supamai Soonthornpun MD**
Affiliation : * Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Songklanakarind Hospital, Prince of Songkla University, Songkhla, Thailand
Background : Simethicone improves endoscopic visibility and diagnostic accuracy during colonoscopy and capsule endoscopy.
Nevertheless, there have been limited data on its usefulness in esophagogastroduodenoscopy (EGD).
Objective : To evaluate the effectiveness of simethicone on enhancing endoscopic visibility in patients undergoing EGD.
Material and Method: 121 patients were randomized to take 2 ml of either liquid simethicone or placebo in 60 ml of water
at 15-30 minutes before EGD. The severity scores of foam and bubbles at the esophagus, stomach and duodenum were
compared.
Results : Simethicone improved endoscopic visibility by diminishing mean cumulative (6.83 + 2.4 vs. 11.05 + 2.6, p < 0.001)
and local scores of foam and bubbles at all areas, and decreased the number and timing of adjunctive simethicone washing
(17.5% vs. 74.1%, p < 0.001 and 0 vs. 19 seconds, p < 0.001). Simethicone increased endoscopist and patient satisfaction
significantly without having adverse effects.
Conclusion : Using simethicone before EGD enhances endoscopic visibility, reduces adjunctive simethicone washing and
increases endoscopist and patient satisfaction.
Keywords : Endoscopic visibility, Esophagogastroduodenoscopy, Simethicone
