A217 SIMETHICONE DECREASES BLOATING AND IMPROVES BOWEL PREPARATION EFFECTIVENESS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
We performed a systematic review and meta-analysis to determine if the addition of simethicone to bowel preparations prior to colonoscopy had an impact on bowel cleanliness and patient tolerability. Simethicone is an adjunct frequently used but there is currently no consensus on whether it should be recommended for routine use in combination with standard bowel preparations. Furthermore, mounting evidence suggests that simethicone adheres to the lining of the working channel on some of the endoscopes despite reprocessing, leading to the formation of biofilms. Given conflicting evidence regarding the effectiveness of simethicone as an adjunct to bowel preparation combined with recent data suggesting simethicone may contribute to biofilm formation, it is important to reassess the potential benefits of simethicone when added to bowel preparation regimes prior to colonoscopy. 1. Determine the effectiveness of simethicone as an adjunct to bowel preparation on bowel cleanliness A comprehensive search was conducted for studies that compared colon cleansing of patients that received standard bowel preparation alone and in combination with simethicone prior to colonoscopy. Only randomized controlled trials were included. The primary outcomes were colon cleanliness and tolerability. Meta-analysis was performed to compare the number of successful bowel preparations amongst patients receiving polyethylene glycol (PEG) versus patients receiving PEG + simethicone. For tolerability, rates of nausea, vomiting, abdominal pain, and abdominal bloating were compared amongst patients receiving PEG versus patients receiving PEG + simethicone. Sixteen randomized controlled trials with 5630 patients were included in meta-analysis. Overall, PEG with simethicone improved colon cleansing compared with PEG alone (OR 1.48, CI 1.11 to 1.97, P = 0.008). This improvement was seen in patients receiving single dosing (OR 1.83, CI 1.20 to 2.79, P = 0.005) but not in patients receiving split dosing (OR 1.32, CI 0.72 to 2.43, P = 0.38). The rates of nausea (OR 0.96, CI 0.75 to 1.24, P = 0.75), vomiting (OR 1.00, CI 0.69 to 1.44, P = 0.99), and abdominal pain (OR 0.69, CI 0.40 to 1.18, P = 0.17) were not significantly different between PEG and PEG + simethicone cohorts. For abdominal bloating, the PEG cohort had greater odds of experiencing bloating than the PEG + simethicone cohort (OR 2.33, CI 1.70 to 3.20, P < .00001). Simethicone, when combined with PEG, resulted in superior colon cleanliness compared to PEG alone. However, this improvement was not seen in patients receiving split-dose PEG, which is now the standard of care. Furthermore, simethicone decreased abdominal bloating but has no effect on nausea, vomiting, and abdominal pain. Figure 1. Successful bowel preparation rates comparing PEG versus PEG + Simethicone None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,016 | 0,043 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».