Gastric Phytobezoars: Coca-Cola an Effective Treatment

Lara C. Pullen, PhD

January 09, 2013

Drinking Coca-Cola appears to be an effective treatment for gastric phytobezoar in 50% of cases, and combining the soda with additional endoscopic methods may lead to resolution of as many as 91.3% of phytobezoars, according to a newly published review.

Spiros D. Ladas, MD, from the Gastroenterology Division, First Department of Medicine–Propaedeutic, Medical School, Athens University, Laikon Hospital, Greece, and colleagues presented the results of their systematic literature review in an article published online December 17, 2012, and in the January 2013 issue of Alimentary Pharmacology and Therapeutics.

The authors searched the literature for the combined keywords "phytobezoars treatment" and "Coca-Cola lysis" and reviewed 24 articles published during a 10-year period between 2002 and 2012. The articles included 46 patients. The authors note that the majority of the articles included in the review did not have patient follow-up, and therefore the review cannot speak to patient relapse.

Although most of the articles were case reports, one was a retrospective study of 17 patients. In their review, Dr. Ladas and colleagues found that only 4 patients (8.7%) who received Coca-Cola treatment went on to develop small bowel obstruction that required surgical treatment. Despite the need for surgery, 3 of the 4 patients still had partial dissolution of their phytobezoars from the Coca-Cola treatment.

The researchers also report that the soda was able to completely dissolve gastric phytobezoars in half of the patients. Although they were unable to state the mechanism of action with certainty, they posit that the soda's pH of 2.6 played an important role in fiber digestion.

Diospyrobezoars (persimmon bezoars) are one of the more difficult types of bezoars to dissolve. They are formed after persimmon ingestion and are characterized by a hard consistency. The authors found that diospyrobezoars were less likely to be completely dissolved by the soda than were phytobezoars (60.6% vs 23%; P = .022).

Physicians seek conservative treatment options, such as dissolution therapies and endoscopic fragmentation techniques, for bezoars, to avoid surgery. The reviewers suggest that Coca-Cola ingestion should be the treatment of choice for gastric phytobezoars because it allows for reduced patient stay in the hospital and may not require endoscopies or equipment. "Moreover," they conclude, "availability, low cost, rapid way of action, simplicity in administration and safety renders Coca-Cola a cost-effective therapy for gastric phytobezoars."

The authors have disclosed no relevant financial relationships.

Aliment Pharmacol Ther. 2013;37:169-173. Full text

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