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Coca-Cola effective as first-line treatment for gastric phytobezoars
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Treatment with Coca-Cola can dissolve gastric phytobezoars, either on its own or as an initial therapy to be followed by endoscopic techniques, according to recent results.
In a systematic review, researchers evaluated 24 studies, involving 46 patients, published between 2002 and 2012, in which the efficacy of Coca-Cola in the dissolution of gastric phytobezoars and diospyrobezoars was assessed.
Patients received Coca-Cola either as a beverage (n=22), lavage (n=16) or combination of drink, irrigation and injection (n=8). Administration varied from 500 mL to 3,000 mL, within a span of 24 hours to 6 weeks.
Nearly all phytobezoars treated with Coca-Cola (91.3%) were fully dissolved, using Coca-Cola alone in half of all cases, with the remainder requiring additional endoscopic techniques including polypectomy snare, mechanical lithotripsy with basket or biopsy forceps, among others. Four patients required surgery for small bowel obstructions, including three who had achieved partial dissolution. Small bowel obstruction also developed in two patients, 1 week and 6 weeks after experiencing complete dissolution.
Investigators noted that phytobezoars were significantly more likely to dissolve than diospyrobezoars after initial treatment with Coca-Cola (60.6% of cases vs. 23%, P=.022). Additional treatment resulted in similar results between phytobezoars and diospyrobezoars, as did surgical intervention (P=.312 for both comparisons).
“This study shows that most gastric phytobezoars can be effectively treated with Coca-Cola administration as less than 10% of the cases necessitate surgery,” the researchers wrote, but added that clinicians should still be aware of the possibility of small bowel obstruction even following complete dissolution. “Coca-Cola ingestion should be the treatment of choice considering that less endoscopies and accessories are needed and patients stay less at the hospital. Moreover, availability, low cost, rapid way of action, simplicity in administration and safety renders Coca-Cola a cost-effective therapy for gastric phytobezoars.”
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