How Much Can Simethicone Do in Colonoscopy?

Meta-analyses suggest that adding simethicone to colonoscopy bowel preparation effectively reduces intraluminal bubbles but does not improve bowel cleansing or adenoma detection.

In a randomized, controlled trial in China, 600 patients were randomized to receive 2 liters of polyethylene glycol (PEG) alone or with 30 mL of simethicone before colonoscopy.

The adenoma detection rate (ADR) and adenomas per colonoscopy were higher with PEG plus simethicone compared with PEG alone (21% vs. 14%, and 2.2 vs. 1.6, respectively). The percentage of patients with a Boston bowel preparation scale score ≥6 was also higher with simethicone (88% vs. 75%), and bubble scores (on a 0–4 scale) were better (mean score, 1.0 vs. 4.0). Also, bloating was less freque…