Mucosal visualization is a key factor in the success of esophagogastroduodenoscopy (EGD). In daily practice, the presence of mucus, foam, and air bubbles often interferes with endoscopic views and may affect diagnostic accuracy, particularly for subtle lesions.

A study by Dr. Fauzi Yusuf, Dr. Azzaki Abubakar, and Dr. Desi Maghfirah, published in Acta Medica Indonesiana – The Indonesian Journal of Internal Medicine, titled “Efficacy and Safety of Pre-Endoscopy Regimens for Mucosal Visualization During Sedated Esophagogastroduodenoscopy: A Randomized Controlled Trial,” evaluated several premedication regimens to improve mucosal visualization during EGD.

This randomized controlled trial involved 168 patients undergoing diagnostic EGD under sedation at Dr. Zainoel Abidin General Hospital, Banda Aceh. Four regimens were compared: simethicone alone, simethicone with sodium bicarbonate, simethicone with N-acetylcysteine (NAC), and a combination of all three agents.

The study found that regimens containing simethicone and N-acetylcysteine were associated with better mucosal visualization compared to several other regimens. In addition, this combination was linked to shorter procedure duration and lower irrigation requirements. From a safety perspective, all regimens demonstrated a good safety profile, with clinical parameters remaining within acceptable limits.

These findings suggest that a relatively simple premedication approach can contribute to improved quality and efficiency of EGD procedures. In clinical practice, the combination of simethicone and N-acetylcysteine may be considered a practical and effective option.

Read the full article:
Acta Medica Indonesiana, Vol. 58 No. 1 (2026)

Cover illustration: Freepik (by halfpoint)