From the Guidelines
Simethicone is generally considered safe with minimal side effects, primarily related to its gas-relieving action, and the most common side effects include belching, gas, and mild stomach discomfort. When considering the administration of simethicone, especially in the context of endoscopy, it's crucial to follow guidelines that minimize potential side effects and ensure effective removal of the substance from endoscopic equipment 1. The American Society for Gastrointestinal Endoscopy guidelines suggest using the lowest concentration (0.5 mL simethicone in 99.5 mL water; 0.5 % v/v; 10 mg/100 mL) and the smallest volume of simethicone if it needs to be administered through the endoscope 1.
Key Considerations for Simethicone Use
- The local action of simethicone in the digestive system contributes to its minimal systemic side effects.
- Common side effects are typically mild and temporary, including belching, gas, and mild stomach discomfort.
- Rare side effects can include allergic reactions such as rash, itching, or swelling.
- It's essential to follow guidelines for the use of simethicone, especially in medical procedures like endoscopy, to minimize side effects and ensure proper equipment reprocessing 1.
Recommendations for Administration
- Use the lowest effective concentration of simethicone.
- Administer the smallest volume necessary.
- Follow standard reprocessing protocols carefully to remove simethicone from endoscopic equipment, recognizing that standard protocols may not be fully effective for the working channel 1.
From the Research
Simethicone Side Effects
- The study 2 found that simethicone had no significant effect on nausea, vomiting, and abdominal pain.
- The rates of nausea, vomiting, and abdominal pain were not significantly different between the polyethylene glycol (PEG) and PEG + simethicone cohorts.
- However, simethicone was found to decrease abdominal bloating, with the PEG cohort having greater odds of experiencing bloating than the PEG + simethicone cohort.
- The study 2 also found that simethicone improves colon cleanliness and adenoma detection rate (ADR), but this improvement is not seen in patients receiving split-dose PEG.
- Simethicone may be a useful bowel preparation adjunct in patients unable to receive split-dose PEG, as it improves colon cleanliness and ADR, and decreases abdominal bloating.