Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2009; 15(18): 2265-2269
Published online May 14, 2009. doi: 10.3748/wjg.15.2265
How good is cola for dissolution of gastric phytobezoars?
Beom Jae Lee, Jong-Jae Park, Hoon Jai Chun, Ji Hoon Kim, Jong Eun Yeon, Yoon Tae Jeen, Jae Seon Kim, Kwan Soo Byun, Sang Woo Lee, Jae Hyun Choi, Chang Duck Kim, Ho Sang Ryu, Young-Tae Bak
Beom Jae Lee, Jong-Jae Park, Hoon Jai Chun, Ji Hoon Kim, Jong Eun Yeon, Yoon Tae Jeen, Jae Seon Kim, Kwan Soo Byun, Sang Woo Lee, Jae Hyun Choi, Chang Duck Kim, Ho Sang Ryu, Young-Tae Bak, Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul 152-703, South Korea
Authors contributions: Lee BJ, Park JJ, Chun HJ designed the study; Lee BJ, Chun HJ, Park JJ, Lee SW, Ryu HS analyzed the data; Lee BJ, Chun HJ, Park JJ drafted the article; Chun HJ, Yeon JE, Kim JS, Choi JH critically revised the article; Park JJ, Chun HJ finally approved the article; Jeen YT, Kim JH, Lee SW, Kim CD, Byun KS, Bak YT, Choi JH provided the study materials or patients.
Correspondence to: Jong-Jae Park, MD, PhD, 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. gi7pjj@yahoo.co.kr
Telephone: +82-2-26262003
Fax: +82-2-8371943
Received: November 26, 2008
Revised: March 12, 2009
Accepted: March 19, 2009
Published online: May 14, 2009
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Gastric phytobezoars; Diospyrobezoars; Cola; Dissolution; Clinical efficacy