How good is cola for dissolution of gastric phytobezoars?

Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-gil 97, Guro-gu, Seoul 152-703, South Korea.
World Journal of Gastroenterology (Impact Factor: 2.37). 06/2009; 15(18):2265-9.
Source: PubMed


To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars.
A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.
After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent complete dissolution (P = 0.006). Gender, symptom duration, size of bezoar and method of cola administration were not significantly different between the two groups. Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation.
The rate of complete dissolution with three liters of cola was 23.5%, but no case of diospyrobezoar was completely dissolved using this method. However, pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.

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Available from: Young-Tae Bak, Nov 19, 2014
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    • "Some small phytobezoars are treated conservatively with nasogastric lavage; however, endoscopic fragmentation is the treatment of choice for most gastroduodenal bezoars. Various endoscopic methods and instruments have been reported, including biopsy forceps, lithotripsy with a basket, polypectomy snare, and argon plasma beam.3 Some recent studies have reported that Coca-Cola infusion directly to a bezoar or nasogastric lavage with Coca-Cola make bezoars soften and shrink. "
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    • "Although there are some medical treatments, they mostly used in cases with mild symptoms and are applied when there is no sign of acute abdomen. Most of these methods refer to ordering “cola” for dissolving phytobezoars.12–15 Surgical intervention should be reserved for those who have acute abdominal conditions or large bezoars. "
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