Oesophageal food impaction in achalasia treated with Coca-Cola and nifedipine

Koumi, Andriani; Panos, Marios Z.

doi:10.1136/bcr.05.2009.1891

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…Tedavide en temel ve öncelikli girişim derhal havayolunun endotrakeal entübasyon ile güvence altına alınması ve takiben de nazo-özofageal sonda yerleştirerek özofagus dekompresyonun sağlan-masıdır. Kimi zaman özofagusun aşırı dilate ve tamamen dolu olduğu durumlarda tekrarlayan entübasyon ve dekompresyona gerek olabilmekte ve böylece hasta artmış aspirasyon, travma ve perforasyon riski ile karşı karşıya kalabilmektedir [14] . Akalazyanın uzun dönem tedavisinde ise pnömatik dilatasyon, endoskopik botulismus toksin (BOTOX) enjeksiyonu gibi endoskopik yöntemler ile Heller myotomi ve özafajektomi gibi cerrahi prosedürler uygulanmaktadır [15] .…”

Section: Discussionunclassified

A Case of Achalasia With Acute Respiratory Insufficiency

Tezer¹,

Di̇kmen²,

Çekmen³

et al. 2014

GKDA Derg

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Section: Discussionunclassified

A Case of Achalasia With Acute Respiratory Insufficiency

Tezer¹,

Di̇kmen²,

Çekmen³

et al. 2014

GKDA Derg

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“…We hypothesised that cola would be successful in 50% of patients, based on previous non-randomised studies on cola treatment reporting food bolus passage in 59-100% of instances. [12][13][14][15] We estimated a 10% chance of spontaneous passage in the control group, simply awaiting emergent endoscopy. Assuming a power of 0.8 and a 5% significance level, a sample size of 40 patients was required.…”

Section: Methodsmentioning

confidence: 99%

“…Previous small studies have reported success rates of cola ingestion doi: 10.1136/bmj-2023-077294 | BmJ 2023;383:e077294 | the bmj ranging from 59% to 100%, with no reported short term adverse events. [12][13][14][15] Carbon dioxide is thought to be responsible for the mechanism of clearing impaction, or disimpaction, by effervescent agents. However, the exact mechanism is unclear.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial

Tiebie,

Baerends,

Boeije

et al. 2023

BMJ

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ObjectiveTo determine the efficacy and safety of cola in resolving complete oesophageal food bolus impaction.DesignOpen label, multicentre, randomised controlled trial.SettingEmergency departments of five Dutch hospitals at the secondary and tertiary level, between 22 December 2019 and 16 June 2022.Participants51 adults presenting with complete oesophageal food bolus impaction, defined as a sudden inability to pass saliva after consumption of foods. Patients who ingested meat that contained bones, and patients with an American Society of Anesthesiologists (ASA) physical status classification of IV or higher were excluded.Interventions28 patients in the intervention group were instructed to consume 25 mL cups of cola at intervals up to a maximum total volume of 200 mL. 23 patients in the control group awaited spontaneous passage. In either group, if complete resolution of symptoms did not occur, endoscopic removal was performed following current guidelines: within 6 hours for patients with complete obstruction, and within 24 hours for partial obstruction. In case of complete resolution of symptoms, elective diagnostic endoscopy was required.Main outcome measuresImprovement of oesophageal food bolus obstruction as reported by patients (ie, aggregate of complete and partial passage), and evaluation of complete passage. The secondary outcome was any intervention related adverse event.ResultsCola did not have a meaningful effect on the improvement of food bolus obstruction (17/28 (61%) interventionv14/23 (61%) control; odds ratio 1.00, 95% confidence interval 0.33 to 3.1; relative risk reduction 0.0, 95% confidence interval −0.55 to 0.36; P>0.99). Complete passage was reported more often in the intervention group but this difference was not significant (12/28 (43%) interventionv8/23 (35%) control; odds ratio 1.4 (0.45 to 4.4); relative risk reduction −0.23 (−1.5 to 0.39); P=0.58). No severe adverse events occurred. However, six (21%) patients in the intervention group experienced temporary discomfort after drinking cola.ConclusionsIn this study, cola consumption did not lead to a higher rate of improvement of complete oesophageal food bolus impaction. Given the lack of adverse events in the treatment group and some events of resolution after treatment, cola might be considered as a first line treatment, but should not delay any planning of endoscopic management.Trial registrationNetherlands Trial Register (currently International Clinical Trial Registry Platform) NL8312.

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“…Those who search online for remedies for stuck food will find that the internet is replete with advice for cola use. Cola has also been advocated as a safe treatment for patients in whom endoscopic removal of a food bolus is judged to be too risky [17] , [18] . Despite its popularity, there is minimal evidence surrounding cola’s use in removing food boluses.…”

Section: Introductionmentioning

confidence: 99%

Cola therapy for oesophageal food bolus impactions a case series

Baerends

Boeije

Capelle

et al. 2019

African Journal of Emergency Medicine

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Introduction This retrospective case series describes the use of cola to immediately treat complete oesophageal food bolus obstructions in the emergency centre. Short of emergent endoscopy – which is invasive, expensive, not without adverse events, and often unavailable in low-resource settings – no other proven therapies exist to relieve oesophageal food impactions. Methods We performed a chart review of adults with complete oesophageal food bolus obstructions presenting to two Dutch emergency centres. Our primary outcome was cola’s success rate in resolving the obstruction. Our secondary outcome was adverse event occurrence. Results We identified 22 cola interventions in 19 patients, the majority of whom (77.3%) were male. The median age was 59 years (IQR 29–73). All presentations were due to meat impaction. Endoscopy revealed relevant upper gastrointestinal pathology in 54.5%. When initiated in the emergency centre, cola successfully resolved 59% of complete oesophageal obstructions. No adverse events were reported in patients successfully treated with cola. Discussion While keenly aware of our retrospective study’s limitations, we found a promising success rate for cola as an acute intervention for oesophageal food bolus impactions. We registered no adverse events attributable to cola. Also, given that cola is cheap, widely available and seemingly safe we believe it can be considered in patients with oesophageal obstructions due to food, either as pre-endoscopy treatment or in case endoscopy is not available at all. We think our findings provide an impetus for prospective research on this intervention.

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Oesophageal food impaction in achalasia treated with Coca-Cola and nifedipine

Cited by 7 publications

References 6 publications

A Case of Achalasia With Acute Respiratory Insufficiency

A Case of Achalasia With Acute Respiratory Insufficiency

Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial

Cola therapy for oesophageal food bolus impactions a case series

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