← Issue №11/ week of Sep 13, 2026/Endoscopy

Topical Vitamin C and N-Acetylcysteine for Reducing Symptoms After Lugol Chromoendoscopy: A Multicenter Randomized Controlled Trial.

From GI Signals issue №11: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy rct · n=681 · Sep 9, 2026 · Clin Transl Gastro · IF 3.4

Topical Vitamin C and N-Acetylcysteine for Reducing Symptoms After Lugol Chromoendoscopy: A Multicenter Randomized Controlled Trial.

New therapyendoscopy quality
Clinical takeawayApply topical 2% vitamin C solution or 10% N-acetylcysteine immediately after Lugol chromoendoscopy to reduce post-procedure discomfort. At 15 minutes, symptom rates drop from 44% (saline) to 8-9%; at 30 minutes from 32% to 4%. This simple intervention requires no special equipment beyond standard endoscopy supplies.
What it foundTopical 2% vitamin C solution and 10% N-acetylcysteine each reduced post-Lugol symptoms to 8.8% and 9.4% incidence at 15 minutes, versus 44.3% with saline (relative risks 0.198 and 0.213), and to 4.2% and 4.1% at 30 minutes (relative risks 0.132 and 0.129).
ContextLugol chromoendoscopy detects esophageal squamous neoplasia effectively but has been limited by short-term pharyngeal and retrosternal discomfort. This is the first randomized evidence that immediate topical application of vitamin C or NAC substantially reduces symptoms, offering a practical in-procedure tool to improve screening tolerance.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Fu X … Tian S · Clinical and Translational Gastroenterology · IF 3.4 · PubMed ↗Permalink
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