***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND STUDY AIMS Ideal bowel preparation for colonoscopy requires complete removal of fluid and foam from the colon . Polyethylene glycol ( PEG ) is widely used for bowel preparation , with antifoaming agents such as simethicone commonly used in combination with PEG . Data on the effect of simethicone on the adenoma detection rate ( ADR ) were limited . This study therefore aim ed to investigate whether preprocedure simethicone could increase the ADR . PATIENTS AND METHODS This was a prospect i ve , multicenter , endoscopist-blinded r and omized controlled trial involving consecutive patients who underwent colonoscopy in six centers in China . Patients were r and omly assigned to one of two groups : PEG plus simethicone or PEG alone . The primary outcome was ADR ; secondary outcomes were quality of bowel preparation , measured by the Boston bowel preparation scale ( BBPS ) and bubble scores . RESULTS 583 patients were included . More adenomas were detected in the PEG plus simethicone group than in the PEG alone group ( ADR 21.0 % vs. 14.3 % , P = 0.04 ; advanced ADR 9.0 % vs. 7.0 % , P = 0.38 ) . The mean number of adenomas detected was 2.20 ± 1.36 vs. 1.63 ± 0.89 ( P = 0.02 ) . Patients in the PEG plus simethicone group showed better bowel cleansing efficacy : BBPS ≥ 6 in 88.3 % vs. 75.2 % ( P < 0.001 ) and bubble scores of 1.00 ± 1.26 vs. 3.98 ± 2.50 ( P < 0.001 ) . Abdominal bloating was reported less frequently in the PEG plus simethicone group ( 7.8 % vs. 19.7 % , P < 0.001 ) than in the PEG alone group . CONCLUSION Combined use of PEG and simethicone is associated with a significantly increased ADR in a Chinese population BACKGROUND AND STUDY AIMS For bowel preparation , using a reduced volume of polyethylene glycol ( PEG ) solution without influencing its effectiveness would be preferable . While simethicone shows great potential as an adjunctive agent , data on its use are limited . We aim ed to clarify whether simethicone added to low-volume PEG solution improved bowel cleansing . PATIENTS AND METHODS : Consecutive adult patients registered for colonoscopy were recruited from seven medical centers in South China between 15 April and 15 July 2015 and prospect ively r and omized into two groups : 2 L PEG ( conventional group ) and 2 L PEG plus simethicone ( simethicone group ) . The primary endpoint was the effectiveness of bowel cleansing according to the Boston Bowel Preparation Scale ( BBPS ) . Secondary endpoints included cecal intubation time , adenoma detection rate ( ADR ) , patient safety and compliance , and adverse events . RESULTS : We included 290 and 289 patients in the conventional and simethicone groups , respectively , for analysis . The proportion with acceptable bowel cleansing ( BBPS ≥ 6 ) was significantly higher in the simethicone group than in the conventional group ( 88.2 % vs. 76.6 % ; P < 0.001 ) . The mean ( SD ) BBPS score was significantly lower in the conventional group ( 6.5 [ 1.8 ] vs. 7.3 [ 1.7 ] ; P < 0.001 ) , as was the bubble score ( 2.5 [ 0.7 ] vs. 2.8 [ 0.5 ] ; P < 0.001 ) . The average cecal intubation time was significantly shorter in the simethicone group ( 6.3 [ 3.1 ] vs. 7.5 [ 5.1 ] minutes ; P < 0.001 ) . The ADR in the right colon was higher in the simethicone group than in the conventional group ( 16.6 % vs. 10.3 % ; P = 0.03 ) . Safety and compliance , including the taste , smell , and dosage of PEG , were similar for both groups . CONCLUSIONS Simethicone added to low-volume PEG solution improves bowel-cleansing efficacy , with similar safety and compliance , shorter cecal intubation time , and higher ADR BACKGROUND 4-L polyethylene glycol preparations are effective for colon cleansing before colonoscopy . However , large volume and unpleasant taste reduce tolerability and acceptability limiting patient compliance . A new isosmotic low-volume polyethylene glycol preparation with citrates and simethicone plus bisacodyl has been developed to improve patient compliance and tolerability . AIM To compare the efficacy of 2 different regimens of preparation vs a split-dose of polyethylene glycol solution . PATIENTS AND METHODS In this r and omised , blinded , comparative study , 153 patients were allocated to 3 arms . Arm 1 ( n=52 ) received bisacodyl and 2-L polyethylene glycol with citrates and simethicone the day before the procedure . Arm 2 ( n=50 ) received bisacodyl the day before and 2-L polyethylene glycol with citrates and simethicone on the day of colonoscopy . Control group ( n=51 ) received a split-dose of 4-L polyethylene glycol .  Cleansing was evaluated according to Ottawa scale . RESULTS The mean Ottawa score was not different in the 3 groups . Excellent cleansing was observed more frequently in arm 2 ( 70 % ) than in controls ( 49 % ) ( p<0.05 ) . No serious adverse events were observed in the 3 regimens . The willingness to repeat the same bowel preparation was superior in arms 1 and 2 than in controls ( p<0.001 ) . CONCLUSIONS New low-volume preparations seem to be as effective as the split 4-L polyethylene glycol regimen , showing a better tolerability and acceptability We have noted that colons of patients prepared for colonoscopy with Golytely , a nonabsorbable electrolyte lavage solution  , frequently contain foam which may obscure small mucosal lesions . Therefore , a r and omized , blinded controlled trial was performed to determine the prevalence of Golytely-induced foam and the effect of supplemental simethicone in decreasing the prevalence of foam . Foam was present in 32 % of colons prepared with Golytely alone but in none of the colons prepared with Golytely supplemented with simethicone . In addition , only 5 % of colons prepared with supplemental simethicone had residual stool noted at the time of colonoscopy , a significant improvement over the 39 % prevalence of residual stool in colons prepared with Golytely alone . Addition of simethicone to Golytely lavage decreases the prevalence of colonic foam and residual stool Background and Aim : Low-volume polyethylene glycol with ascorbic acid ( PEG-Asc ) use is reported to be as safe and effective as traditional 4-L polyethylene glycol use . However , PEG-Asc produces bubbles , which cause problems during colonoscopy . Data on the effects of using antifoaming agents such as simethicone with PEG-Asc are lacking . The aim of this CONSORT- prospect i ve , r and omized , observer-blinded , controlled trial is to compare the quality of bowel preparation and compliance between PEG-Asc users and PEG-Asc plus simethicone users . Methods : Adult out patients aged 18 to 80 years undergoing colonoscopy were recruited to the study . Two hundred sixty patients were r and omly assigned to 1 of 2 treatment arms , PEG-Asc or PEG-Asc plus simethicone . The primary outcome measure was the bowel cleansing quality using Boston bowel preparation scale and bubble scores . The secondary outcome measures were patient tolerability and doctor tolerability . Results : The simethicone group showed superior cleansing results ( 6–9 Boston scale scores : 99 % vs. 84 % , < 5 % bubble scores : 96 % vs. 49 % , P < 0.001 ) and fewer gastrointestinal symptoms ( abdominal fullness : 24 % vs. 55 % , colicky pain : 5 % vs. 24 % , P < 0.001 ) than the non-simethicone group . Moreover , endoscopist fatigue during colonoscopy was lower in the simethicone group than in the non-simethicone group ( 1.31 ± 0.75 vs. 2.97 ± 2.14 , P < 0.001 ) . Conclusion : PEG-Asc plus simethicone use was more effective and associated with better patient and endoscopist tolerance than PEG-Asc use . Therefore , this combination is recommended as one of the promising methods for bowel preparation before colonoscopy OBJECTIVES : Colonic bubbles associated with polyethylene glycol-electrolyte solution ( PEG-ELS ) are common and obscure mucosal visualization . This study aim ed to determine whether adding simethicone decreases the incidence of bubbles . METHODS : Prospect i ve , single-blind , r and omized comparison of split dose PEG-ELS vs. PEG-ELS+simethicone ( PEG-S ) for outpatient colonoscopy . Bubble severity for colonic segments was assessed on withdrawal as A = no/minimal bubbles , B = moderate bubbles/interfere with detecting 5 mm polyp , C = severe bubbles/interfere with detecting 10 mm polyp . Primary end point was Grade B or C bubbles in any colon segment . Secondary end points were cleansing quality , incidence and severity of side effects , and polyp detection . RESULTS : One hundred and thirty nine patients enrolled ; 13 withdrew before colonoscopy . Of 123 patients evaluated , 62 took PEG-S and 61 PEG-ELS . The incidence of grade B or C bubbles was much lower with PEG-S compared with PEG-ELS ( 2 % vs. 38 % ; P=0.001 ) . Overall cleansing ( excellent or good ) quality was not significantly different for either the whole colon ( 89 % PEG-ELS , 94 % of PEG-S , P=0.529 ) or right colon ( 88 % PEG-ELS , 94 % PEG-S , P=0.365 ) . More PEG-S patients had excellent rather than good preps ( whole colon 53 % vs. 28 % , P=0.004 ; right colon 53 % vs. 35 % , P=0.044 ) . Need for any flushing was less with PEG-S ( 38 % vs. 70 % , P=0.001 ) . The groups were not significantly different with respect to total procedure and withdrawal times , incidence or severity of side effects , or number of polyps/patient or adenomas/patient . CONCLUSIONS : Adding simethicone to PEG-ELS effectively eliminates bubbles , substantially reduces the need for flushing , and results in more excellent preparations AIM To compare the bowel cleansing efficacy , tolerability and acceptability of split 2-L polyethylene glycol (PEG)-citrate-simethicone ( PEG-CS ) plus bisacodyl ( BIS ) vs 4-L PEG for fecal occult blood test-positive screening colonoscopy . METHODS This was a r and omised , observer-blind comparative study . Two hundred and sixty-four subjects underwent screening colonoscopy ( mean age 62.5 ± 7.4 years , male 61.7 % ) . The primary objective of the study was to compare the bowel cleansing efficacy of the two preparations . INTERVENTIONS BIS plus PEG-CS : 3 tablets of 5-mg BIS at 16:00 , PEG-CS 1-L at 19:00 and 1-L at 7:00 , 4-L PEG : 3-L at 17:00 , and 1-L at 7:00 . Colonoscopy was carried out after 11:00 , at least 3 h after the completion of bowel preparation . Bowel cleansing was evaluated using the Harefield Cleansing Scale . RESULTS Bowel preparation was successful for 92.8 % of subjects in the PEG-CS group and for 92.1 % of subjects in the 4-L PEG ( RR = 1.01 ; 95%CI : 0.94 - 1.08 ) . BIS + PEG-CS was better tolerated  than 4-L PEG . A greater rate of patients in the BIS + PEG-CS group had no difficulty and /or were willing to repeat the same preparation compared to split-dose 4-L PEG group . Subjects in the BIS + PEG-CS group rated the prep as good or satisfactory in 90.6 % as compared to 77 % in the 4-L PEG ( P = 0.003 ) . Subjects receiving BIS + PEG-CS stated they fully adhered to instructions drinking all the 2-L solution in 97.1 % compared with 87.3 % in the 4-L PEG ( P = 0.003 ) . CONCLUSION BIS plus split 2-L PEG-CS was as effective as but better tolerated and accepted  than split 4-L PEG for screening colonoscopy . This new procedure may increase the positive attitude and participation to colorectal cancer screening colonoscopy Background 
    Output:
    
Simethicone improves colon cleanliness and ADR ; however , this improvement is not seen in patients receiving split-dose PEG .
Furthermore , simethicone decreases abdominal bloating but has no effect on nausea , vomiting , and abdominal pain .
Simethicone may be a useful bowel preparation adjunct in patients unable to receive split-dose PEG