 All patients will take a standard small bowel preparation consisting of the following starting the day before the procedure: clear fluids starting at lunch, two liters of PEG at 8 PM, and fasting starting at midnight. Patients arrive in the endoscopy unit at 6:45 AM the following morning. Randomization is performed via REDCap and simethicone given as follows: those randomized to high volume simethicone will drink a 750 ml solution 1125 mg simethicone diluted in 750 ml of water, 1.5 mgml and those randomized to standard volume simethicone will drink a 200 ml solution 300 mg simethicone diluted in 200 ml of water, 1.5 mgml in identical non-transparent lidded cups sealed with tamper tape prepared by the hospitals Clinical Trials Pharmacy and administered to the patient by the research nurse. Regardless of randomization results, the solution will be consumed over a 5 minute period and the patient instructed to resume fasting for 30 minutes before swallowing the capsule. Adherence will be assessed by collection of the cups after ingestion. 