In a recent study published in BMJResearchers conducted a randomized controlled trial (RCT) to evaluate the safety and effectiveness of Coke in reducing esophageal bolus impaction.
background
The main treatment for esophageal food retention is emergency endoscopy, which is cumbersome and expensive. Studies have reported that cola reduces food impaction, minimizing the burden on emergency personnel and endoscopy personnel.
Coke is inexpensive and widely available, and if proven effective, it could be made available to patients in residential or primary care settings, reducing emergency department visits and emergency endoscopy visits. There is sex. However, some pharmacotherapies have had limited or contradictory results.
About research
In this multicenter, open-label RCT, researchers compared cola intake to compared to
Researchers conducted an RCT from December 22, 2019 to June 16, 2022 in the emergency departments of four secondary-level and one tertiary-level hospitals in the Netherlands. The study included 51 people over the age of 18 who presented to the emergency department with a complete esophagus. Fecal impaction of food. It is described as a sudden complete inability of saliva to pass after ingesting food, and the sensation of food getting stuck between the oropharyngeal and epigastric tissues during swallowing.
The researchers identified meat with bones, American Society of Anesthesiologists (ASA) status class IV or higher, conservative treatment (nitrates, glucagon, soda, or nifedipine), food particles visible on oral exam, or severe We excluded individuals with aspiration risk (Glasgow Coma Scale). Under 14 years of age or previous relevant aspirations) from the study.
Emergency department registrars and physicians randomly enrolled patients into study groups on a one-to-one basis. The research team collected socio-demographic and health data from the emergency department through a questionnaire and recorded information regarding esophageal bolus obstruction (e.g. nature of food, duration of fecal impaction, previous obstruction, known esophageal pathology). Did.
In total, participants in the treatment group (n=28) consumed one cup of Coca-Cola at a rate of 25 mL per minute (maximum volume, 8 sips of 25 mL for 200 mL). Individuals in the control group (n=23) did not undergo endoscopic pretreatment and waited for food passage. If symptoms persist, an endoscopic procedure to remove the affected food may be performed within 6 hours for complete esophageal obstruction and within 1 day for partial esophageal obstruction, according to current guidelines. I got it.
Elective diagnostic endoscopy was required if symptoms resolved completely. The primary outcome of the study was an improvement in patient-reported assessment of esophageal food obstruction (i.e., a collection of partial and complete passages) and complete passages. Secondary outcomes included treatment-related adverse events graded using the Adverse Events Gastrointestinal Endoscopy (AGREE) system.
result
The median age of participants in the treatment and control groups was 58 and 54 years, respectively. This study included primarily male participants. Most fecal impactions were caused by ingestion of meat, fried potatoes, bread, and sauerkraut. Of her 41 patients with fecal impaction, 41% (9 of 22) of treated patients and 37% (7 of 19) of controls reported completely passing food. . Among 10 people consuming other foods, 50% (3 of 6) of treated patients and 25% (1 of 4) of controls reported complete passage of the food bolus Did.
Coke intake did not significantly improve food blockage [17 out of 28 individuals (61%) in the treatment group vs. 14 out of 23 (61%) in the control group; odds ratio (OR), 1.0; relative risk (RR) reduction of 0.0]. Treated patients reported complete food passage more frequently.However, the difference was not significant [12 out of 28 (43%) treatment recipients vs. 8 out of 23 (35%) controls; OR, 1.4; RR reduction of 0.2].
This study found that 18% of treated patients and 26% of controls completed partial bolus passage within 40 and 45 minutes, respectively. However, 21% of participants in the treatment group experienced temporary discomfort after ingesting cola without requiring intervention or prolonged hospitalization in the emergency department. Cola intake ranged from 25 mL to 125 mL, with an average consumption of 50 mL. There were no adverse events requiring immediate or emergent endoscopic procedures, and mucosal lesions occurred in two of his patients in the treatment group and four controls.
Twelve were affected by the meal for less than an hour, and 63% of treated patients experienced complete resolution. In the treatment group, 79% of 28 participants underwent elective, emergency, or emergent endoscopy, whereas 78% of 41 participants had esophageal lesions. Twenty participants reported complete resolution, 10 did not undergo diagnostic endoscopy, and 6 died during follow-up. The researchers found no significant differences between the study groups or between those who experienced food passage and those who did not.
Study results showed that cola intake did not significantly improve complete esophageal bolus implantation. Current guidelines recommend follow-up of all cases of bolus impaction and further investigation of the benefits of cola in early or partial esophageal impaction.
