Premedication with oral solution of simethicone plus N-acetylcysteine to improve the quality upper GI endoscopy: initial experience

Girolamo Geraci^*, Beatrice D’Orazio, Salvatore Fazzotta, Attilio Ignazio Lo Monte, Gaetano Giuseppe Di Vita

University of Palermo, Department of Surgical, Oncological and Oral Sciences, Italy

Introduction: To assess the efficacy and safety of simethicone with or without N-acetylcysteine (NAC) as premedications before gastroscopy.

Materials and methods: Patients were randomized into 5 groups. Endoscopic visibility was evaluated in 4 districts (esophagus, gastric body, fundus and antrum) using a visual scale, graduating from 1 to 4 points.

Results: There was no significant difference on the rate of positive findings when comparing simethicone with simethicone plus NAC and with water, respectively. Simethicone plus NAC showed better total mucosal visibility score than simethicone alone. Both simethicone plus NAC and simethicone alone offer more benefit than water. The procedure time in simethicone group was shorter than that in water group. Regarding adverse events, there was no significant difference in simethicone and water group.

Conclusions: As premedication of gastroscopy, simethicone plus NAC offers more benefit on positive findings and total mucosal visibility score.