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DOI: 10.1055/s-0040-1704853
SIMETHICONE CLEARS THE WAY FOR CAPSULES
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Aims Capsule endoscopy is a useful test for small bowel (SB) disease. Image quality as with all endoscopic tests can vary; Simethicone has been recommended to improve image quality by the ESGE but is not routinely used in our practice.
To assess the impact of Simethicone addition on capsule quality
Methods A prospective uncontrolled pilot study. Consecutive patients were given 100mg of Simethicone (Wind-Eze) over 2 months in accordance with ESGE recommendations. Cases were compared to matched controls from our capsule endoscopy (CE) database. Outcome measures were reported image quality, completion rates and diagnostic yield. Groups were compared using Chi-2 test, P< 0.05 was considered significant.
Results 96 capsules were reviewed, 32 cases and 64 controls. The mean age was 52yrs (range 18-86) and 42 (44%) were males. Indications were Iron Deficiency Anaemia (IDA) 40% (n=38), Crohn’s disease (CD) 35% (n=34) and others 25% (n=24); there was no difference between groups P=0.9. Image quality did not differ between cases and controls being good/excellent in 11/32 (34%) vs 23/64 (36%) respectively, P=0.5. Diagnostic yield was also similar between groups, 16/32 (50%) vs 36/64 (56%). However, completion rates were higher in the Simethicone group, 59/64 (92%) vs 100%, P=0.03. Of note, there were no reported side effects.
Conclusions Similar to international results, Simethicone did not improve overall diagnostic yield. Unlike previous studies we found no improvement in image quality. However, the improved completion rates possibly due to less friction and air pockets; thus improving transit warrants further investigation.