THE EFFECTIVENESS OF SIMETHICONE IN IMPROVING VISIBILITY DURING COLONOSCOPY WHEN GIVEN WITH A SODIUM-PHOSPHATE SOLUTION - A DOUBLE-BLIND RANDOMIZED STUDY

Background: Oral sodium phosphate solution is better tolerated than po lyethylene glycol when used for colonoscopy preparation, but visibilit y of the lumen can be impaired because of the presence of bubbles. Met hods: We studied 86 patients receiving either simethicone (n = 42) or placebo (n = 44) in addition to oral sodium phosphate to determine if simethicone improved visibility during colonoscopy. Patients were rand omized to receive 160 mg of simethicone or a placebo with 45 ml of sod ium phosphate the evening before and the morning of colonoscopy. Colon oscopy was performed by a single blinded investigator. Five areas of t he colon (rectosigmoid, descending, transverse, ascending, and cecum) were assessed for the presence of bubbles on withdrawal of the endosco pe. Bubbles were scored as follows: 0, minimal or none; 1, covering ha lf the lumen; 2, covering the entire circumference; 3, filling the ent ire lumen. Results: Thirteen patients in the placebo group and only on e in the simethicone had significant bubbles (greater than or equal to 1). Additionally, the mean bubble scores were greater in the placebo group in each region of the colon (p less than or equal to 0.05 in rec tosigmoid and ascending colon). Conclusions: This study indicates that taking simethicone with an oral sodium phosphate preparation can impr ove colonic visibility by diminishing the presence of bubbles. Better visualization could improve detection of mucosal pathologic lesions.