simethicone and Intestinal-Diseases

Presence of significant quantities of gas in the intestines may hinder a proper conduction of abdominal ultrasonography. In humans, preparatory techniques are used to solve this, but measures to avoid ultrasonographic complications due to intestinal gas in rabbits have not been reported. The objective of this study was to evaluate the influence of fasting and simethicone administered orally on the quality of ultrasonographic images of the gallbladder, kidneys, and jejunum in adult New Zealand White (NZW) rabbits. A total of 28 adult NZW rabbits were included in a crossover design study, involving four groups: F: fasting for 4-6 h before the examination; FS: fasting and application of simethicone (20 mg/kg, orally) 20 to 30 min before the examination; S: application of simethicone 20-30 min before the examination without fasting; and C: controls without fasting and no application of simethicone. Evaluation of the ultrasonographic images was done in terms of percentage of visualization of each organ and image quality using a 3-point scoring system (unacceptable, acceptable, or excellent). The kidneys and the gallbladder were visualized at an equal frequency in all groups, while the jejunum was visualized more frequently in the FS group. The image quality scores for gallbladder, right kidney, and left kidney was similar for all groups, but for the jejunum, a higher number of images with acceptable scores was found within the FS group.

Topics: Administration, Oral; Animals; Antifoaming Agents; Cross-Over Studies; Fasting; Gallbladder; Intestinal Diseases; Jejunum; Kidney; Rabbits; Simethicone; Ultrasonography

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

To evaluate the effects of the various methods of small bowel preparation on the quality of visualization of the small bowel and the gastrointestinal transit time of capsule endoscopy (CE).. Ninety patients referred for CE were prospectively randomized to three equal groups according to the preparation used: (a) a control group, in which patients were requested to drink 1 L of clear liquids only, 12 h before the examination; (b) a purgative group, in which patients were requested to ingest 1 L of a polyethylene glycol (PEG)/electrolyte solution only, 12 h before the examination; or (c) a purgative combined with simethicone group (P-S group), in which patients were requested to ingest 1 L of PEG, 12 h before the examination, and 300 mg of simethicone, 20 min before the examination. Effects of the different bowel preparations on the gastric transit time (GTT), small bowel transit time (SBTT), examination completion rate, quality of images of the entire small intestine, and cleansing of the proximal small bowel and distal ileum were evaluated.. The number of patients with "adequate" cleansing of the entire small intestine was 17 in the P-S group, 12 in the purgative group, and seven in the control group (P= 0.002). The P-S group had significantly better image quality than the control group (P= 0.001). The P-S group had significantly better image quality for the proximal small bowel (segment A [Seg A]) than the control group (P= 0.0001). Both the P-S group (P= 0.0001) and the purgative group (P= 0.0002) had significantly better image quality for the distal ileum (segment B [Seg B]) than the control group; the P-S group had significantly better image quality than the purgative group as well (P= 0.0121). Gastrointestinal transit time was not different among the three groups, nor was the examination completion rate.. Purgative bowel cleansing combined with simethicone before CE improved the quality of imaging of the entire small bowel as well as the visualization of the mucosa in the proximal and distal small intestine.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antifoaming Agents; Capsule Endoscopy; Child; Drug Administration Routes; Female; Follow-Up Studies; Gastrointestinal Transit; Humans; Intestinal Diseases; Intestine, Small; Male; Polyethylene Glycols; Prospective Studies; Reproducibility of Results; Simethicone; Surface-Active Agents

Bowel preparation for capsule endoscopy (CE) has not been standardized.. This study aimed to compare CE images between patients prepared by simethicone and those prepared by magnesium citrate.. Retrospective analysis of case series of our hospital from 2004 to 2007.. Single center.. CE images of 75 patients receiving bowel preparation either by 200 mg of simethicone (n=39) or by 34 g of magnesium citrate (n=36) were retrospectively investigated. Grades of fluid transparency and mucosal invisibility by air bubbles and food residue were compared between the 2 preparations. Capsule transit time, frequency of positive findings, and interobserver variations between 2 observers were also investigated.. Image quality and diagnostic yield of CE.. Fluid transparency in the first and the third time segments of the small intestine was better in patients prepared by magnesium citrate than in those prepared by simethicone (P= .001 and P= .03, respectively). On the other hand, mucosal invisibility was not different in any part of the small intestine between the 2 groups. Neither gastric transit time nor small-bowel transit time was different between the 2 groups. The diagnostic yield of CE correlated significantly with fluid transparency (P= .04), but it did not correlate with mucosal invisibility.. Single-center retrospective study.. Magnesium citrate seems to be a recommended preparation for CE compared with simethicone. The fluid transparency, rather than the mucosal invisibility, may be a factor associated with the diagnostic yield of CE.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Capsule Endoscopy; Citric Acid; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Image Enhancement; Intestinal Diseases; Intestine, Small; Male; Middle Aged; Organometallic Compounds; Patient Compliance; Premedication; Retrospective Studies; Sensitivity and Specificity; Simethicone; Therapeutic Irrigation; Young Adult

Capsule studies can be reviewed by varying rates and speeds; however, the presence of significant debris is frustrating to the reviewer much like the excessive stool that tends to hinder the progress of a colonoscopist. Numerous studies have been published in regards to the advantages of an ideal preparation in the setting of capsule endoscopy. This most recent study by Wei et al. is another study that has demonstrated that a colonic preparation, in this situation, combined with simethicone given just prior to the capsule study results in improved visibility of the mucosa. In theory, this will lead to an improved diagnostic ability to limit excessive reading duration.

Topics: Antifoaming Agents; Capsule Endoscopy; Drug Administration Routes; Gastrointestinal Transit; Humans; Intestinal Diseases; Intestine, Small; Polyethylene Glycols; Reproducibility of Results; Simethicone; Surface-Active Agents

The purpose of this work was to study the appearance of infantile colic and gas discomfort and to learn whether these problems are associated with factors in the child's social environment, allergic symptoms, or feeding. The study was made retrospectively by means of a questionnaire which was sent to mothers of every tenth child aged 14 to 38 months in Turku, Finland. Forty percent of the children, as many boys as girls, had colic or gas problems in early infancy, so severe in 20% that drug therapy was used. First born children in the family more often had colic and gas problems than did subsequent children. Siblings of colicky children had colic and gas problems more often than did siblings of the children who had no colic or gas problems. Neither family history or symptoms of allergy, duration of breast-feeding, mother's consumption of plain cow's milk during lactation, nor the age of introduction of cow's milk to the child were associated with the occurrence of colic. Children with colic grew as well as children without. However, their night sleep was more often disturbed by awakenings than the night sleep of children without colic or gas problems in early infancy.

Topics: Age Factors; Breast Feeding; Colic; Female; Finland; Gases; Humans; Hypersensitivity; Infant; Infant Nutritional Physiological Phenomena; Intestinal Diseases; Intestines; Male; Retrospective Studies; Risk; Simethicone