Usefulness of Butylscopolamine in Upper Gastrointestinal X-ray Examination

Abstract

Objective: To clarify whether butylscopolamine (BS) administration is useful in visualizing the upper gastrointestinal (GI) tract on x-ray examination.

Methods: We included patients who had undergone upper GI x-ray examination from August 2015 to August 2019. To eliminate the bias of gastrointestinal peristalsis, we excluded patients with diabetes mellitus, Parkinson’s disease, anticholinergic drug use, intestinal motility promoter drug use, and previous gastrectomy. To adjust for confounding factors, propensity scores for BS administration adjusted for age, sex, body mass index, height, examiner, and presence or absence of chronic gastritis findings were produced, and propensity score matching was performed to establish the BS and non-BS administration groups. For evaluating visualization, the upper GI tract was divided into 15 areas, and one point was given for each area if poor visualization was present due to poor dilatation. If poor visualization was present due to overlapping of the intestine, one point was given if the area of overlap was the size of the antrum. These points were combined to create a poor visualization score. The poor visualization scores in the BS and non-BS groups were compared.

Results: Of 8,679 cases, 233 patients in the BS group and 235 patients in the non-BS group were included in the analysis. The proportion of patients with a poor visualization score ≥4 was 11.6% (27/233) in the BS group and 20.4% (48/235) in the non-BS group. The score was significantly lower in the BS group (p=0.011).

Conclusion: BS administration may improve visualization in upper GI x-ray examination.