Oral IBGard™ Before Colonoscopy: A Single-Center Double-Blinded, Randomized, Placebo-Controlled Trial
| Autor: | William E. Karnes, Erica Duh, Zain Moosvi, Sunhee Park, James Y. Han, Gregory C. Albers, Jason B. Samarasena |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.diagnostic_test
Physiology business.industry medicine.medical_treatment Gastroenterology Placebo-controlled study Colonoscopy Single Center Placebo Polypectomy law.invention stomatognathic diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Oral administration law 030220 oncology & carcinogenesis Anesthesia Medicine Intubation 030211 gastroenterology & hepatology business |
| Zdroj: | Digestive Diseases and Sciences. 66:1611-1619 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Peppermint oil is well known to inhibit smooth muscle contractions, and its topical administration during colonoscopy is reported to reduce colonic spasms. We aimed to assess whether oral administration of IBGard™, a sustained-release peppermint oil formulation, before colonoscopy reduces spasms and improves adenoma detection rate (ADR). We performed a single-center randomized, double-blinded, placebo-controlled trial. Patients undergoing screening or surveillance colonoscopies were randomized to receive IBGard™ or placebo. The endoscopist graded spasms during insertion, inspection, and polypectomy. Bowel preparation, procedure time, and time of drug administration were documented. Statistical analysis was performed using the Student’s t test and Wilcoxon rank-sum test. There was no significant difference in baseline characteristics or dose-timing distribution between IBGard™ and placebo groups. Similarly, there was no difference in ADR (IBGard™ = 47.8%, placebo = 43.1%, p = 0.51), intubation spasm score (1.23 vs 1.2, p = 0.9), withdrawal spasm score (1.3 vs 1.23, p = 0.72), or polypectomy spasm score (0.52 vs 0.46, p = 0.69). Limiting the analysis to patients who received the drug more than 60 min prior to the start of the procedure did not produce any significant differences in these endpoints. This randomized controlled trial failed to show benefit of orally administered IBGard™ prior to colonoscopy on the presence of colonic spasms or ADR. Because of its low barrier to widespread adoption, the use of appropriately formulated and timed oral peppermint oil warrants further study to determine its efficacy in reducing colonic spasms and improving colonoscopy quality. |
| Databáze: | OpenAIRE |
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