Effect of Simethicone on Colon Preparation During Water Exchange Colonoscopy
23 juni 2026 bijgewerkt door: Dalin Tzu Chi General Hospital
Effects of Simethicone on Colon Preparation in Water Exchange Colonoscopies: a Randomized Controlled Study
Background: Colonoscopy reduces colorectal cancer mortality by enabling early detection and removal of adenomas.
Its effectiveness, however, depends heavily on bowel preparation quality and mucosal visibility.
Simethicone, an anti-foaming agent, decreases intraluminal bubbles and improves visualization; studies in conventional air-insufflation colonoscopy generally show benefits for cleanliness and patient comfort, but evidence in water-exchange (WE) colonoscopy remains limited.Objective: To evaluate whether adding oral simethicone to a split-dose polyethylene glycol (PEG) regimen further improves bowel cleanliness and procedural performance in WE colonoscopy.Methods: Adults undergoing outpatient colonoscopy will be randomly assigned (1:1) to a simethicone group or a control group, with a planned enrollment of 180 participants.
All procedures will use the WE insertion technique, and endoscopists will be blinded to group allocation.
The primary endpoint is the Boston Bowel Preparation Scale (BBPS); adequate preparation is defined as a total score ≥6 with all segment scores ≥2.
Secondary endpoints include bubble score and CEBuS, adenoma detection rate (ADR), polyp detection rate (PDR), cecal intubation rate and time, withdrawal time, volume of water used and flushing/irrigation metrics, and patient-reported tolerability and satisfaction.Expected Results: Compared with PEG alone, adding simethicone is expected to (1) increase the proportion of adequate BBPS preparations, (2) reduce bubble coverage, (3) maintain or potentially improve ADR/PDR, and (4) enhance patient tolerability and satisfaction.Conclusion:
If effective, this intervention would provide a simple, low-cost strategy to optimize the quality of WE colonoscopy.
Studie Overzicht
Toestand
Nog niet aan het werven
Conditie
Interventie / Behandeling
Studietype
Ingrijpend
Inschrijving (Geschat)
180
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Chih -Wei Tseng
- Telefoonnummer: +886-5-2648000
- E-mail: cwtseng2@gmail.com
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Ja
Beschrijving
Inclusion Criteria:
- Consecutive patients undergoing screening, surveillance, or diagnostic colonoscopy.
- Procedures performed by participating endoscopists.
- Ability to provide written informed consent.
Exclusion Criteria:
- Colonoscopy performed using air insufflation or water immersion technique.
- History of colorectal surgery (e.g., colectomy or colostomy).
- Known or suspected colonic obstruction or severe stricture.
- Requirement for inpatient bowel preparation.
- Known allergy or hypersensitivity to simethicone.
- Unable or unwilling to provide informed consent.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Onderzoek naar gezondheidsdiensten
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Without simethicone group
follow a bowel preparation protocol consisting of 10 mg of bisacodyl and 2 liters of PEG solution.
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All participants followed a standardized bowel preparation protocol consisting of 10 mg of bisacodyl and 2 liters of PEG solution administered in a split-dose regimen.
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Experimenteel: With simethicone group
Participants received a total of 30 mL of simethicone, with 15 mL added to each 1-liter dose of polyethylene glycol (PEG) solution in the split-dose regimen.
|
All participants followed a standardized bowel preparation protocol consisting of 10 mg of bisacodyl and 2 liters of PEG solution administered in a split-dose regimen.
Participants in the simethicone group additionally received 30 mL of simethicone (600 mg), with 15 mL added to each 1-liter dose of PEG solution.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Boston bowel preparation scale (BBPS)
Tijdsspanne: At the time of colonoscopy.
|
Bowel preparation quality assessed using the Boston Bowel Preparation Scale (BBPS).
Adequate preparation is defined as a total score ≥6 with all segment scores ≥2.
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At the time of colonoscopy.
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Bubble score assessed using a 4-point bubble scale
Tijdsspanne: During the colonoscopy procedure.
|
Bubble score assessed during colonoscopy using a 4-point scale (0-3) for each colon segment, where higher scores indicate more bubbles.
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During the colonoscopy procedure.
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Colon Endoscopic Bubble Scale(CEBuS)
Tijdsspanne: During the colonoscopy procedure.
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Bowel cleanliness assessed using the Colon Endoscopic Bubble Scale (CEBuS), categorized based on the percentage of mucosal surface obscured by bubbles (e.g., <5%, 5-50%, >50%).Higher scores indicate poorer visibility due to bubbles.
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During the colonoscopy procedure.
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Adenoma detection rate (ADR)
Tijdsspanne: one week
|
one week
|
|
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Polyp detection rate (PDR)
Tijdsspanne: one week
|
one week
|
|
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Cecal intubation rate
Tijdsspanne: At the time of colonoscopy.
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Proportion of procedures in which the cecum is successfully reached.
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At the time of colonoscopy.
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Cecal intubation time
Tijdsspanne: During the colonoscopy procedure.
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Time from insertion to successful cecal intubation, measured in minutes.
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During the colonoscopy procedure.
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Withdrawal time
Tijdsspanne: During the colonoscopy procedure.
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Time from cecal intubation to scope withdrawal, measured in minutes.
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During the colonoscopy procedure.
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Volume of water infused
Tijdsspanne: During the procedure.
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Total volume of water infused during colonoscopy, measured in milliliters.
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During the procedure.
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Volume of fluid aspirated
Tijdsspanne: During the procedure
|
Total volume of fluid aspirated during colonoscopy, measured in milliliters.
|
During the procedure
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Patient-reported pain score
Tijdsspanne: Immediately after the procedure.
|
Pain assessed using a visual analog scale (VAS) ranging from 0 (no pain) to 10 (worst pain imaginable).
|
Immediately after the procedure.
|
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Patient satisfaction score
Tijdsspanne: Immediately after the procedure.
|
Patient satisfaction assessed using a numeric rating scale from 0 to 10, where higher scores indicate greater satisfaction.
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Immediately after the procedure.
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Tongprasert S, Sobhonslidsuk A, Rattanasiri S. Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation. World J Gastroenterol. 2009 Jun 28;15(24):3032-7. doi: 10.3748/wjg.15.3032.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
- Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687-96. doi: 10.1056/NEJMoa1100370.
- Lebwohl B, Kastrinos F, Glick M, Rosenbaum AJ, Wang T, Neugut AI. The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy. Gastrointest Endosc. 2011 Jun;73(6):1207-14. doi: 10.1016/j.gie.2011.01.051. Epub 2011 Apr 8.
- Cao RR, Wang L, Gao C, Pan JH, Yoshida EM, Li HY, Qi XS. Effect of oral simethicone on the quality of colonoscopy: A systematic review and meta-analysis of randomized controlled trials. J Dig Dis. 2022 Mar;23(3):134-148. doi: 10.1111/1751-2980.13084. Epub 2022 Mar 14.
- Sun M, Yang G, Wang Y. Cleaning effect and tolerance of 16 bowel preparation regimens on adult patients before colonoscopy: a network meta-analysis. Int J Colorectal Dis. 2023 Mar 11;38(1):69. doi: 10.1007/s00384-023-04355-3.
- Zhang S, Zheng D, Wang J, Wu J, Lei P, Luo Q, Wang L, Zhang B, Wang H, Cui Y, Chen M. Simethicone improves bowel cleansing with low-volume polyethylene glycol: a multicenter randomized trial. Endoscopy. 2018 Apr;50(4):412-422. doi: 10.1055/s-0043-121337. Epub 2017 Nov 13.
- Joao M, Areia M, Alves S, Elvas L, Brito D, Saraiva S, Cadime AT. The Effect of Oral Simethicone in a Bowel Preparation in a Colorectal Cancer Screening Colonoscopy Setting: A Randomized Controlled Trial. GE Port J Gastroenterol. 2023 Jun 15;31(2):116-123. doi: 10.1159/000530866. eCollection 2024 Apr.
- Bai Y, Fang J, Zhao SB, Wang D, Li YQ, Shi RH, Sun ZQ, Sun MJ, Ji F, Si JM, Li ZS. Impact of preprocedure simethicone on adenoma detection rate during colonoscopy: a multicenter, endoscopist-blinded randomized controlled trial. Endoscopy. 2018 Feb;50(2):128-136. doi: 10.1055/s-0043-119213. Epub 2017 Oct 6.
- Moolla M, Dang JT, Shaw A, Dang TNT, Tian C, Karmali S, Sultanian R. Simethicone decreases bloating and improves bowel preparation effectiveness: a systematic review and meta-analysis. Surg Endosc. 2019 Dec;33(12):3899-3909. doi: 10.1007/s00464-019-07066-5. Epub 2019 Aug 26.
- Menees SB, Elliott E, Govani S, Anastassiades C, Judd S, Urganus A, Boyce S, Schoenfeld P. The impact of bowel cleansing on follow-up recommendations in average-risk patients with a normal colonoscopy. Am J Gastroenterol. 2014 Feb;109(2):148-54. doi: 10.1038/ajg.2013.243.
- Sharma P, Burke CA, Johnson DA, Cash BD. The importance of colonoscopy bowel preparation for the detection of colorectal lesions and colorectal cancer prevention. Endosc Int Open. 2020 May;8(5):E673-E683. doi: 10.1055/a-1127-3144. Epub 2020 Apr 17.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Geschat)
1 augustus 2026
Primaire voltooiing (Geschat)
1 mei 2028
Studie voltooiing (Geschat)
1 september 2028
Studieregistratiedata
Eerst ingediend
3 maart 2026
Eerst ingediend dat voldeed aan de QC-criteria
23 juni 2026
Eerst geplaatst (Werkelijk)
29 juni 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
29 juni 2026
Laatste update ingediend die voldeed aan QC-criteria
23 juni 2026
Laatst geverifieerd
1 februari 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- A11403003
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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