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Pre-gastroscopy drink of simeticone and NAC improves mucosal visibility during procedure

A new study has found that a pre-procedure drink containing simeticone and NAC significantly improves mucosal visibility during gastroscopy and reduces the need for flushes during the procedure. Effectiveness in the lower oesophagus demonstrates potential benefit in Barrett’s oesophagus surveillance gastroscopy.

The research gastroenterology team at Queen Alexandra Hospital, run by Portsmouth Hospitals NHS Trust, ran a study involving 126 patients who were undergoing routine gastroscopy.

The randomised controlled trial examined the impact of a pre-gastroscopy drink containing the mucolytic agent N-acetylcysteine and defoaming agent simeticone on mucosal visibility during routine outpatient gastroscopy. Two control groups were used, one receiving water, and the other no preparation. The endoscopists performing study procedures and the 4 separate endoscopists who assessed the study images were all blinded to group allocation.

Analysis of the primary outcome showed significant improvements in mucosal visibility in the group receiving the active study medication compared to both control groups. Hence the findings of the study are in keeping with those of several previous studies demonstrating improvements in gastric mucosal visibility with a pre-gastroscopy drink containing a mucolytic and a defoaming agent.

This has the potential to become part of standard pre- gastroscopy preparation to improve the detection of upper gastrointestinal neoplasia.

The full paper, ‘A randomised controlled trial of pre-procedure simeticone and N-acetylcysteine to improve mucosal visibility during gastroscopy – NICEVIS’, can be found in Endoscopy International Open.