Is current UK management of oesophageal food bolus obstruction evidence based? An e-mail survey and literature review.
There is a great deal of variation in individual management of non-sharp oesophageal food bolus obstruction in the United Kingdom. An e-mail survey of consultants and specialist registrars in ENT was carried out to establish current UK practice. A review of the published literature was under-taken to establish whether current practice is evidence based. The majority of practitioners (95%) do not proceed immediately to rigid oesophagoscopy but use antispasmodic drugs (83%), most commonly hyoscine butylbromide (Buscopan) and diazepam, to try to induce spontaneous passage of the obstruction. There is currently no evidence in the published literature to support the use of these drugs. The use of Buscopan seems to have been encouraged by a misquoted reference in a prominent ENT textbook. Better evidence is needed to establish the best form of treatment for this relatively common problem.
Price
T
T
Norfolk and Norwich University Hospital, Norwich, UK. timothy.price@nhs.net
Jones
S E M
SE
Montgomery
P Q
PQ
D001569:Benzodiazepines / Q000627:therapeutic use; D002086:Butylscopolammonium Bromide / Q000627:therapeutic use*; D002253:Carbonated Beverages; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D003975:Diazepam / Q000627:therapeutic use*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D004945:Esophagoscopy; D019317:Evidence-Based Medicine; D005502:Food; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005934:Glucagon / Q000627:therapeutic use; D006801:Humans; D018482:Muscle, Skeletal / Q000503:physiopathology; D009130:Muscle, Smooth / Q000503:physiopathology; D009566:Nitrates / Q000627:therapeutic use; D010036:Otolaryngology / Q000706:statistics & numerical data; D010276:Parasympatholytics / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D012042:Registries; D012601:Scopolamine / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D006113:United Kingdom
D005765:Gastrointestinal Agents; D009566:Nitrates; D010276:Parasympatholytics; D001569:Benzodiazepines; D002086:Butylscopolammonium Bromide; D005934:Glucagon; D012601:Scopolamine; D003975:Diazepam