The role of liquid simethicone in enhancing endoscopic visibility prior to Esophagogastroduodenoscopy (EGD): A prospective, randomized, double-blinded, placebo-controlled trial

Abstract

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.