simethicone and magnesium-carbonate

Capsule endoscopy (CE) is limited by incomplete small-bowel transit and poor view quality in the distal bowel. Currently, there is no consensus regarding the use of bowel purgatives or prokinetics in CE.. To evaluate the usefulness of bowel purgatives and prokinetics in small-bowel CE.. Prospective single-blind randomized controlled study.. Academic endoscopy unit.. A total of 150 patients prospectively recruited.. Patients were randomized to 1 of 4 preparations: "standard" (fluid restriction then nothing by mouth 12 hours before the procedure, water and simethicone at capsule ingestion [S]); "standard" + 10 mg oral metoclopramide before the procedure (M); Citramag + senna bowel-purgative regimen the evening before CE (CS); Citramag + senna + 10 mg metoclopramide before the procedure (CSM).. Gastric transit time (GTT) and small-bowel transit time (SBTT), completion rates (CR), view quality, and patient acceptability.. positive findings, diagnostic yield.. No significant difference was noted among groups for GTT (median [minutes] M, CS, and CSM vs S: 17.3, 24.7, and 15.1 minutes vs 16.8 minutes, respectively; P = .62, .18, and .30, respectively), SBTT (median [minutes] M, CS, and CSM vs S: 260, 241, and 201 vs 278, respectively; P = .91, .81, and .32, respectively), or CRs (85%, 85%, and 88% vs 89% for M, CS, and CSM vs S, respectively; P = .74, .74, and 1.00, respectively). There was no significant difference in view quality among groups (of 44: 38, 37, and 40 vs 37 for M, CS, and CSM, vs S, respectively; P = .18, .62, and .12, respectively). Diagnostic yield was similar among the groups. CS and CSM regimens were significantly less convenient (P < .001), and CS was significantly less comfortable (P = .001) than standard preparation.. Bowel purgatives and prokinetics do not improve CRs or view quality at CE, and bowel purgatives reduce patient acceptability.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Capsule Endoscopy; Cathartics; Citric Acid; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Female; Gastrointestinal Motility; Gastrointestinal Transit; Humans; Intestinal Diseases; Intestine, Small; Magnesium; Male; Metoclopramide; Middle Aged; Premedication; Prospective Studies; Senna Extract; Simethicone; Single-Blind Method; Young Adult

A study was made of the effect of 6 commonly used gastrointestinal preparations on the absorption of propranolol using an in vitro experimental model. The constituents examined were activated dimethicone, aluminium hydroxide gel, bismuth carbonate, kaolin, magnesium carbonate, and magnesium trisilicate. A slight decreased propranolol absorption was given by kaolin (-13.0%), the other components showed smaller effects ranging from -6.8% to +6.6%. None of the results were statistically significantly different from control absorption values.

Topics: Aluminum Hydroxide; Animals; Antacids; Bismuth; Carbonates; In Vitro Techniques; Intestinal Absorption; Kaolin; Magnesium; Magnesium Silicates; Propranolol; Rats; Silicic Acid; Silicones; Simethicone