Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population
Background and study aim Pre-endoscopic use of a preparation with tensioactive and mucolytic agents improved gastric mucosa visualization in Eastern studies. Data on Western population are scanty. Patients and methods This prospective, endoscopist-blinded, randomized study enrolled patien...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1315-0114 |
| _version_ | 1818665994589044736 |
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| author | Guido Manfredi Roberto Bertè Elena Iiritano Saverio Alicante Claudio Londoni Giancarlo Brambilla Samanta Romeo Fernanda Menozzi Paola Griffanti Giovanna Brandi Oliva Moreschi Raffaele Pezzilli Angelo Zullo Elisabetta Buscarini |
| author_facet | Guido Manfredi Roberto Bertè Elena Iiritano Saverio Alicante Claudio Londoni Giancarlo Brambilla Samanta Romeo Fernanda Menozzi Paola Griffanti Giovanna Brandi Oliva Moreschi Raffaele Pezzilli Angelo Zullo Elisabetta Buscarini |
| author_sort | Guido Manfredi |
| collection | DOAJ |
| description | Background and study aim Pre-endoscopic use of a preparation with tensioactive and mucolytic agents improved gastric mucosa visualization in Eastern studies. Data on Western population are scanty.
Patients and methods This prospective, endoscopist-blinded, randomized study enrolled patients who underwent esophagogastroduodenoscopy in a single center. Before endoscopy patients, were randomized to receive or not receive an oral preparation with simethicone and N-acetylcysteine in water. A pretested score (Crema Stomach Cleaning Score [CSCS]) for gastric mucosa cleaning evaluation was used. In detail, the stomach was divided into the antrum, body, and fundus and a score of 1 to 3 was assigned to each part (the higher the score, the better the preparation), and a total value ≤ 5 was considered as insufficient. Time between endoscope insertion and clean achievement (mouth to clean time) or the end of examination (mouth to mouth time) was recorded.
Results A total of 197 patients were enrolled. The mean overall CSCS value and mucosal cleaning in all parts was better in treated patients than in controls. Prevalence total score ≤ 5 was significantly lower in patients treated before endoscopy. Need for water flush occurred less frequently in treated patients (P < 0.0001). The mouth to clean time was lower in the treated than in the control group (2.3 ± 1.6 vs 3.8 ± 1.6 min; P < 0.001), whereas no significant difference in mouth to mouth time emerged.
Conclusions Data from this study show that premedication with simethicone and N-acetylcysteine results in significantly better endoscopic visualization of gastric mucosa, and the proposed CSCS could be useful for standardizing this evaluation. |
| first_indexed | 2024-12-17T05:57:29Z |
| format | Article |
| id | doaj.art-7439ba3f415f40a5bc82137a95395ba0 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-17T05:57:29Z |
| publishDate | 2021-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-7439ba3f415f40a5bc82137a95395ba02022-12-21T22:00:58ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362021-01-010902E190E19410.1055/a-1315-0114Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western populationGuido Manfredi0Roberto Bertè1Elena Iiritano2Saverio Alicante3Claudio Londoni4Giancarlo Brambilla5Samanta Romeo6Fernanda Menozzi7Paola Griffanti8Giovanna Brandi9Oliva Moreschi10Raffaele Pezzilli11Angelo Zullo12Elisabetta Buscarini13Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Gastroenterology Department, ‘San Carlo’ Hospital, Potenza, ItalyGastroenterology, ‘Nuovo Regina Margherita’ Hospital, Rome, ItalyGastroenterology and Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy Background and study aim Pre-endoscopic use of a preparation with tensioactive and mucolytic agents improved gastric mucosa visualization in Eastern studies. Data on Western population are scanty. Patients and methods This prospective, endoscopist-blinded, randomized study enrolled patients who underwent esophagogastroduodenoscopy in a single center. Before endoscopy patients, were randomized to receive or not receive an oral preparation with simethicone and N-acetylcysteine in water. A pretested score (Crema Stomach Cleaning Score [CSCS]) for gastric mucosa cleaning evaluation was used. In detail, the stomach was divided into the antrum, body, and fundus and a score of 1 to 3 was assigned to each part (the higher the score, the better the preparation), and a total value ≤ 5 was considered as insufficient. Time between endoscope insertion and clean achievement (mouth to clean time) or the end of examination (mouth to mouth time) was recorded. Results A total of 197 patients were enrolled. The mean overall CSCS value and mucosal cleaning in all parts was better in treated patients than in controls. Prevalence total score ≤ 5 was significantly lower in patients treated before endoscopy. Need for water flush occurred less frequently in treated patients (P < 0.0001). The mouth to clean time was lower in the treated than in the control group (2.3 ± 1.6 vs 3.8 ± 1.6 min; P < 0.001), whereas no significant difference in mouth to mouth time emerged. Conclusions Data from this study show that premedication with simethicone and N-acetylcysteine results in significantly better endoscopic visualization of gastric mucosa, and the proposed CSCS could be useful for standardizing this evaluation.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1315-0114 |
| spellingShingle | Guido Manfredi Roberto Bertè Elena Iiritano Saverio Alicante Claudio Londoni Giancarlo Brambilla Samanta Romeo Fernanda Menozzi Paola Griffanti Giovanna Brandi Oliva Moreschi Raffaele Pezzilli Angelo Zullo Elisabetta Buscarini Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population Endoscopy International Open |
| title | Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population |
| title_full | Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population |
| title_fullStr | Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population |
| title_full_unstemmed | Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population |
| title_short | Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population |
| title_sort | premedication with simethicone and n acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a western population |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1315-0114 |
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