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Background Simethicone is an anti-foaming agent which can be used to decrease the surface tension of air bubbles and improve visualization of colonic mucosa during colonoscopy. Recent studies have found that residual simethicone persists in endoscopes despite reprocessing and disinfection and promotes persistent moisture in endoscope channels. Simethicone residues can theoretically contribute to biofilm formation by providing nutritional milieu for microbial growth, which could increase the risk of transmission of infections among patients. Endoscopists’ perceptions on simethicone use and potential benefits are unknown, and this study aims to start filling this gap. Aims To assess experience and perceptions of simethicone use during colonoscopy in North America. Methods A REDCap® survey was distributed via email to members of various national professional associations and personal contacts of the study authors. Once the survey is complete, logistic regression analysis will be performed to assess univariate and multivariate associations of simethicone use. Preliminary data are reported in this abstract. Results 47 practicing endoscopists have responded so far, of which 31 (64%) are surgeons and 16 are gastroenterologists (34%). The participants had been in practice for a median of eight years (range 1 – 34 years) and performed a median of ten colonoscopies per week. All 47 endoscopists practiced in Canada, with representation from seven provinces. Two endoscopists (4%) ask patients to use simethicone orally as part of their bowel preparation. During outpatient colonoscopy, 22 endoscopists (47%) never use simethicone, 19 endoscopists (40%) use simethicone less than 50% of the time, and six endoscopists (13%) use simethicone more than 50% of the time. Endoscopists were divided as to whether certain bowel preparations influenced their use of simethicone (agree or strongly agree 9, 19%; neutral 29, 62%; disagree or strongly disagree 9, 19%), that simethicone use could contribute to the transmission of pathogens through endoscopes (agree or strongly agree 6, 13%; neutral 34, 72%; disagree or strongly disagree 7, 15%), or that simethicone use increases their adenoma detection rate (agree or strongly agree 18, 38%; neutral 21, 45%; disagree or strongly disagree 8, 17%). Conclusions Of the current respondents of this survey, just over half (53%) of endoscopists report using simethicone during outpatient colonoscopies. Most reported simethicone use was via the water pump or instrument channel; oral simethicone use maybe minimal. Current respondents were divided in their perception that type of bowel preparation influences their use of simethicone or that simethicone use could contribute to the transmission of pathogens. Many endoscopists believed simethicone use could increase their adenoma detection rate. Funding Agencies None

A172 EXPERIENCE AND PERCEPTIONS OF SIMETHICONE USE DURING COLONOSCOPY: A SURVEY OF NORTH AMERICAN ENDOSCOPISTS