Premedication with pronase of N-acetylcysteine improves visibility during gastroendoscopy: An endoscopist-blinded, prospective, randomized study

Chun Chao Chang, Sheng-Hsuan Chen, Chih Ping Lin, Ching Ruey Hsieh, Horng Yuan Lou, Fat Moon Suk, Shiann Pan, Ming Shun Wu, Jun Nan Chen, Yung Fa Chen

Research output: Contribution to journalArticle

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Abstract

Aim: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. Methods: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. Results: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P <0.001 and P <0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P <0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together. Conclusion: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.

Original languageEnglish
Pages (from-to)444-447
Number of pages4
JournalWorld Journal of Gastroenterology
Volume13
Issue number3
Publication statusPublished - Jan 21 2007

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Pronase
Premedication
Acetylcysteine
Prospective Studies
Gastrointestinal Endoscopy
Pylorus
Stomach
Urease
Water
Serology
Endoscopy
Histology
Sensitivity and Specificity
Infection

Keywords

  • Gastrointestinal endoscopy
  • H pylori
  • N-acetylcysteine
  • Pronase

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Premedication with pronase of N-acetylcysteine improves visibility during gastroendoscopy : An endoscopist-blinded, prospective, randomized study. / Chang, Chun Chao; Chen, Sheng-Hsuan; Lin, Chih Ping; Hsieh, Ching Ruey; Lou, Horng Yuan; Suk, Fat Moon; Pan, Shiann; Wu, Ming Shun; Chen, Jun Nan; Chen, Yung Fa.

In: World Journal of Gastroenterology, Vol. 13, No. 3, 21.01.2007, p. 444-447.

Research output: Contribution to journalArticle

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abstract = "Aim: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. Methods: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. Results: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P <0.001 and P <0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P <0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5{\%} and 93.9{\%}, respectively, in groups premedicated with pronase and NAC together. Conclusion: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.",
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author = "Chang, {Chun Chao} and Sheng-Hsuan Chen and Lin, {Chih Ping} and Hsieh, {Ching Ruey} and Lou, {Horng Yuan} and Suk, {Fat Moon} and Shiann Pan and Wu, {Ming Shun} and Chen, {Jun Nan} and Chen, {Yung Fa}",
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AU - Chen, Sheng-Hsuan

AU - Lin, Chih Ping

AU - Hsieh, Ching Ruey

AU - Lou, Horng Yuan

AU - Suk, Fat Moon

AU - Pan, Shiann

AU - Wu, Ming Shun

AU - Chen, Jun Nan

AU - Chen, Yung Fa

PY - 2007/1/21

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N2 - Aim: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. Methods: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. Results: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P <0.001 and P <0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P <0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together. Conclusion: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.

AB - Aim: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. Methods: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. Results: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P <0.001 and P <0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P <0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together. Conclusion: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.

KW - Gastrointestinal endoscopy

KW - H pylori

KW - N-acetylcysteine

KW - Pronase

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