How good is cola for dissolution of gastric phytobezoars?
OBJECTIVE
To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Lee
Beom-Jae
BJ
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.
Park
Jong-Jae
JJ
Chun
Hoon-Jai
HJ
Kim
Ji-Hoon
JH
Yeon
Jong-Eun
JE
Jeen
Yoon-Tae
YT
Kim
Jae-Seon
JS
Byun
Kwan-Soo
KS
Lee
Sang-Woo
SW
Choi
Jae-Hyun
JH
Kim
Chang-Duck
CD
Ryu
Ho-Sang
HS
Bak
Young-Tae
YT
D000368:Aged; D001630:Bezoars / Q000628:therapy*; D002253:Carbonated Beverages; D030221:Cola / Q000737:chemistry*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach