Conservative management of oesophageal soft food bolus impaction

Abstract

Mehta 2001 {published data only}Mehta DI, Attia MW, Quintana EC, Cronan KM. Glucagon use for esophageal coin dislodgment in children: a prospective, Conservative management of oesophageal so food bolus impaction (Review)

Timing and Outcomes of Endoscopy for Esophageal Food Bolus Impaction

“…Previous surveys of patients with food impaction have yielded scanty data on age and gender. 8,9 Our cohort data did not reveal a particular gender predominance and an increasing incidence with age. There were 15 patients in their 7th decade of life, 15 in their 8th decade and 10 in their 9th decade.…”

“…1 Prior to 30 years ago, rigid esophagoscopy performed with the patient under general anesthesia was the standard method of disimpaction used in most hospitals. Subsequently, flexible endoscopic management in the ED using conscious sedation and, more recently, monitored anesthesia care or rarely general anesthesia [2][3][4][5][6][7][8] became common. Most endoscopists prefer bolus extraction, but pushing the bolus into the stomach using the endoscope has also been suggested 2 In most series, patients with EFBI have been designated as having "foreign bodies" and have been included with patients who swallowed objects, such as coins, pins, razors, and batteries.…”

Acute onset dysphagia and neck pain after eating

“…Historically, patients with food bolus obstruction were given intramuscular hyoscine butylbromide to relax oesophageal smooth muscle; and disimpaction rates of 100%,4 80%,5 and 57%6 have been reported in small cohort and case studies when fizzy drinks were given. However, systematic reviews78 found no evidence to recommend that any medical intervention is more effective than “watching and waiting.”78…”

Acute food impaction in an adult with previously undiagnosed eosinophilic esophagitis

“…Esophageal dysmotility and fibrostenosis cause food bolus obstruction, which, if left untreated, can lead to dehydration, pulmonary aspiration and esophageal perforation within 24 hours. 3 …”

“…Esophageal dysmotility and fibrostenosis cause food bolus obstruction, which, if left untreated, can lead to dehydration, pulmonary aspiration and esophageal perforation within 24 hours. 3 Esophageal eosinophilia (≥ 15 eosinophils per high power field) and exclusion of other potential causes of tissue eosinophilia (proton pump inhibitor therapy, Crohn disease, malignant disease, autoimmunity, drug hypersensitivity and parasitic disease) and endoscopy help confirm eosinophilic esophagitis. 4 Patients are asked to swallow (not inhale) fluticasone (440-880 µg twice daily), avoiding food or drink for 30 minutes afterward.…”