Ingestion of Simethicone After Capsule Ingestion and Its Impact on Quality of Video Capsule Endoscopy- a Pilot Study

June 25, 2018 updated by: Gurjiwan Virk, Albany Medical College
Wireless video capsule endoscopy (VCE) is a non-invasive technology that looks into small intestine and gives images of its lumen as the wireless capsule passes through it. It is used widely to access this anatomically difficult part of the body that cannot be seen via either colonoscopy or endoscopy. Currently various studies have been done that give multiple comparisons between various bowel preparation in terms of quality of the small bowel visualization. No studies have been done where simethicone (Gas-X) is ingested after capsule swallowing. We intend to give patients simethicone 1 hour after capsule ingestion for two consecutive hours and compare results of capsule endoscopy outcomes like small bowel transit time (SBTT), diagnostic yield (DY), small bowel visualization quality (SBVQ) and completion rate (CR).

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Currently various studies have been done that give multiple comparisons between various bowel preparation in terms of small bowel transit time (SBTT), diagnostic yield (DY), small bowel visualization quality (SBVQ), completion rate (CR). Studies suggest that using Polyethylene glycol (PEG) prep is significantly better compared to clear liquid and overnight fast in terms if SBVQ and DY (Rokkas et al 2009). Other studies have shown using simethicone 30 minutes before capsule ingestion increases visibility compared to clear liquid and PEG preparation but no significant difference in gastrointestinal transit time or examination completion rate (Wei et al 2008). No studies have been done where simethicone is ingested after capsule swallowing.

Simethicone helps absorb the air bubble in the lumen which can improve the image quality. It decreases the surface tension of gas bubbles thereby dissolving them and preventing gas pockets from forming in GI system. It's often used over the counter for gas relief. Gastric emptying time is usually less than 5 hours, small bowel transit time is usually less than 6 hours, and colonic transit time is usually less than 59 hours (Rao et al 2009). Giving simethicone till 2 hours after swallowing capsule can help clear gas bubble before the capsule migrates into the small bowel.

Albert et al 2004 gave patients 80mg simethicone before swallowing the wireless capsule for their study. Wei et al 2008 gave 300mg of simethicone 20 minutes before swallowing the capsule. Chen et al 2011 gave 20ml (40mg/ml) simethicone 30 minutes before capsule ingestion which amounts to 800 mg total. Current FDA recommendation for adults is 500mg maximum daily dose. The liquid form comes in concentration of 20mg/0.3ml which constitutes to 7.5 ml for 500mg dose.

Study Type

Interventional

Enrollment (Anticipated)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • New York
      • Albany, New York, United States, 12208
        • Recruiting
        • Albany Medical Center
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • patients aged 18 and older
  • patients undergoing capsule endoscopy for standard of care
  • patients able to give consent for themselves

Exclusion Criteria:

• prisoners

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control

First group: Control

Follow the current standard protocol used at Albany Medical Center that includes:

  • Do not drink anything for an additional 2 hours after swallowing pill cam. After which patient may drink clear liquids
  • Do not eat solid food until 4 hours after swallowing. After which patient may eat light that includes soup, toast.
  • Return to clinic (RTC) 8 hours after to remove equipment
  • Avoid carbonated beverages and gas forming foods for the completion of the 8-hours study period
Sham Comparator: Sham
  • Receive 3 ml simethicone 20 minutes prior to capsule swallowing
  • Do not drink anything for an additional 2 hours after swallowing pill cam. After which patient may drink clear liquids
  • Do not eat solid food until 4 hours after swallowing. After which patient may eat light that includes soup, toast.
  • Return to clinic (RTC) 8 hours after to remove equipment
  • Avoid carbonated beverages and gas forming foods for the completion of the 8-hours study period.
Giving simethicone before and after capsule ingestion.
Experimental: Experiment
  • Receive 3 ml simethicone 20 minutes prior to capsule swallowing.
  • Receive 3 ml simethicone 1 hours after capsule swallowing
  • Receive 1.5 ml simethicone 2 hours after capsule swallowing
  • Do not drink anything for an additional 1 hour after taking last simethicone dose. After which patient may drink clear liquids
  • Do not eat solid food until 4 hours after swallowing. After which patient may eat light that includes soup, toast.
  • Return to clinic (RTC) 8 hours after to remove equipment
  • Avoid carbonated beverages and gas forming foods for the completion of the 8-hours study period.
Giving simethicone before and after capsule ingestion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Small bowel visualization quality (SBVQ)
Time Frame: 8 hours
8 hours

Secondary Outcome Measures

Outcome Measure
Time Frame
Small bowel transit time (SBTT),
Time Frame: 8 hours
8 hours
Diagnostic yield (DY)
Time Frame: 8 hours
8 hours
completion rate (CR)
Time Frame: 8 hours
8 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Asra Batool, MD, Albany Medical College
  • Principal Investigator: Gurjiwan s Virk, MD, Albany Medical College

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 3, 2017

Primary Completion (Anticipated)

March 1, 2019

Study Completion (Anticipated)

June 1, 2019

Study Registration Dates

First Submitted

May 23, 2017

First Submitted That Met QC Criteria

May 23, 2017

First Posted (Actual)

May 25, 2017

Study Record Updates

Last Update Posted (Actual)

June 26, 2018

Last Update Submitted That Met QC Criteria

June 25, 2018

Last Verified

June 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

  • 4849

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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