Simethicone use during gastrointestinal endoscopy

position statement of the Gastroenterological Society of Australia

Benedict M. Devereaux*, Andrew C. F. Taylor, Eugene Athan, David J. Wallis, Robyn R. Brown, Sue M. Greig, Fiona K. Bailey, Karen Vickery, Elizabeth Wardle, Dianne M. Jones

*Corresponding author for this work

Research output: Contribution to journalReview article

Abstract

Concern has been raised regarding the use of simethicone, a de-foaming agent, during endoscopic procedures. Following reports of simethicone residue in endoscope channels despite high level disinfection, an endoscope manufacturer recommended that it not be used due to concerns of biofilm formation and a possible increased risk of microorganism transmission. However, a detailed mucosal assessment is essential in performing high-standard endoscopic procedures. This is impaired by bubbles within the gastrointestinal lumen. The Gastroenterological Society of Australia's Infection Control in Endoscopy Guidelines (ICEG) Committee conducted a literature search utilizing the MEDLINE database. Further references were sourced from published paper bibliographies. Following a review of the available evidence, and drawing on extensive clinical experience, the multidisciplinary ICEG committee considered the risks and benefits of simethicone use in formulating four recommendations. Published reports have documented residual liquid or crystalline simethicone in endoscope channels after high level disinfection. There are no data confirming that simethicone can be cleared from channels by brushing. Multiple series report benefits of simethicone use during gastroscopy and colonoscopy in improving mucosal assessment, adenoma detection rate, and reducing procedure time. There are no published reports of adverse events related specifically to the use of simethicone, delivered either orally or via any endoscope channel. An assessment of the risks and benefits supports the continued use of simethicone during endoscopic procedures. Strict adherence to instrument reprocessing protocols is essential.

Original languageEnglish
Pages (from-to)2086-2089
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume34
Issue number12
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • colonoscopy
  • endoscope reprocessing
  • endoscopy
  • gastrointestinal
  • gastroscopy
  • simethicone

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  • Cite this

    Devereaux, B. M., Taylor, A. C. F., Athan, E., Wallis, D. J., Brown, R. R., Greig, S. M., ... Jones, D. M. (2019). Simethicone use during gastrointestinal endoscopy: position statement of the Gastroenterological Society of Australia. Journal of Gastroenterology and Hepatology (Australia), 34(12), 2086-2089. https://doi.org/10.1111/jgh.14757