title: Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment.
abstract: BACKGROUND
  Gastric phytobezoars represent the most common bezoars in patients with poor gastric motility. A variety of dissolution therapies and endoscopic fragmentation techniques have been evaluated as conservative treatment so as to avoid surgery.
  
  
  OBJECTIVE
  To investigate the effectiveness of Coca-Cola for gastric phytobezoars dissolution.
  
  
  METHODS
  We performed a systematic search to identify publications on gastric phytobezoars to assess the efficacy of Coca-Cola as a dissolution therapy. Diospyrobezoars, formed after persimmon ingestion, are a distinct type of phytobezoars characterized by their hard consistency. Thus, these two subgroups of bezoars were compared in terms of successful dissolution.
  
  
  RESULTS
  Over a 10-year period (2002-2012), 24 papers including 46 patients have been published. In 91.3% of the cases, phytobezoar resolution with Coca-Cola administration was successful, either as a single treatment (50%) or combined with further endoscopic techniques, whereas only 4 patients underwent surgery. Phytobezoars were more likely to dissolve after initial attempt with Coca-Cola compared with diospyrobezoars (60.6% vs. 23%, P = 0.022).
  
  
  CONCLUSIONS
  Coca-Cola alone is effective in gastric phytobezoar dissolution in half of the cases and, combined with additional endoscopic methods, is successful in more than 90% of them.
authors.affiliation: Gastroenterology Division, First Department of Medicine - Propaedeutic, Medical School, Athens University, Laikon Hospital, Athens, Greece.
authors.forename: S D
authors.initials: SD
authors.lastname: Ladas
authors.forename: D
authors.initials: D
authors.lastname: Kamberoglou
authors.forename: G
authors.initials: G
authors.lastname: Karamanolis
authors.forename: J
authors.initials: J
authors.lastname: Vlachogiannakos
authors.forename: I
authors.initials: I
authors.lastname: Zouboulis-Vafiadis
mesh_terms: D001630:Bezoars / Q000628:therapy*; D002253:Carbonated Beverages; D005751:Gastric Lavage / Q000379:methods*; D005769:Gastrointestinal Motility / Q000502:physiology; D041981:Gastrointestinal Tract / Q000187:drug effects; D006801:Humans; D013270:Stomach