How good is cola for dissolution of gastric phytobezoars?

Table 1 Basal characteristics of 17 consecutive patients

Case no.	Gender	Age	Symptoms	Duration (d)	Comorbidity	Type of bezoar	Endoscopic findings	Size of bezoar
CD group
1	F	69	Indigestion	21	None	Phytobezoar	GU	Above 50%
2	F	62	Epigastric soreness	21	DM	Phytobezoar	GU	Above 50%
3	F	49	Indigestion, epigastric soreness	14	DM	Phytobezoar	Pyloric stenosis	Below 50%
4	F	51	Indigestion	20	DM	Phytobezoar	GU	Below 50%
PD group
5	M	48	Epigastric soreness	8	None	Phytobezoar	DU scar with stenosis	Below 50%
6	F	57	Indigestion	21	None	Diospyrobezoar	Pyloric stenosis	Above 50%
7	M	71	Indigestion	90	None	Diospyrobezoar	Pyloric stenosis	Below 50%
8	F	65	Epigastric soreness	10	HTN	Diospyrobezoar	Pyloric stenosis	Above 50%
9	F	61	Indigestion	14	DM	Diospyrobezoar	Pyloric stenosis	Below 50%
10	F	57	Indigestion	21	None	Diospyrobezoar	Pyloric stenosis	Below 50%
11	F	67	Epigastric soreness	60	DM	Diospyrobezoar	GU	Below 50%
12	M	63	Epigastric soreness	21	HTN	Phytobezoar	Pyloric stenosis	Above 50%
13	M	78	Indigestion	30	DM	Diospyrobezoar	GU	Above 50%
14	F	75	Epigastric soreness	90	DM	Diospyrobezoar	None	Below 50%
15	F	54	None	7	HTN	Diospyrobezoar	GU	Below 50%
16	F	61	Nausea and vomiting	7	None	Diospyrobezoar	GU	Below 50%
17	M	63	Epigastric soreness	30	None	Diospyrobezoar	Pyloric stenosis	Above 50%

GU: Gastric ulcer; DM: Diabetes mellitus; CD: Complete dissolution; PD: Partial dissolution.

Table 2 Results of cola administration and endoscopic intervention

Case no.	Initial methodof colaadministration	Methods ofendoscopic treatment	Endoscopicprocedure time (min)	No. ofendoscopicsessions (n)	No. of used instruments(n)	Total amount of administered cola (liters)	Hospitalstay (d)
CD group
1	3 L drink			0	0	3	2
2	3 L lavage			0	0	3	2
3	3 L lavage			0	0	3	3
4	3 L lavage			0	0	3	2
PD group
5	3 L drink	Mechanical lithotripsy	8	1	1	6	3
6	3 L lavage	Mechanical lithotripsy	45	1	1	6	3
7	3 L drink	Mechanical lithotripsy	14	1	2	6	2
8	3 L lavage	Mechanical lithotripsy	44	1	1	6	3
9	3 L drink	Mechanical lithotripsy	62	1	2	6	4
10	3 L lavage	Mechanical lithotripsy	42	1	1	6	3
11	3 L lavage	Mechanical lithotripsy	50	1	1	6	7
12	3 L lavage	Mechanical lithotripsy	30	1	1	6	3
13	3 L lavage	Polypectomy snare	52	2	2	9	3
14	3 L drink	Polypectomy snare	40	2	3	6	5
15	3 L drink	Polypectomy snare	58	2	3	9	5
16	3 L drink	Polypectomy snare	62	1	4	6	5
17	3 L drink	Polypectomy snare	72	2	5	6	3

Table 3 Comparison of clinical characteristics between complete dissolution and partial dissolution groups

	CD group (n = 4)	PD group (n = 13)	Pvalue
Age, range (yr)	51-69	48-78	0.412
Gender (M:F)	0:4	5:8	0.208
Symptom duration, range (d)	14-21	7-90	0.624
Median (d)	20	21
Type of bezoar			0.006
Phytobezoar	4	2
Diospyrobezoar	0	11
Size of bezoar			0.559
Over than 50% of stomach	2	5
Less than 50% of stomach	2	8
Endoscopic findings			0.241
GU	3	5
Gastric outlet stenosis	1	8
Method of administration of cola			0.441
Lavage	3	6
Oral drink	1	7

Table 4 Summary of cases for gastric phytobezoar treated with cola

Author	Type of bezoars	No. of cases	Methods of administration of Coca-cola	Duration of Coca-cola
Ladas et al[6]	Phytobezoar	5	3 L of Coca-cola lavage	12 h
Kato et al[7]	Diospyrobezoars	1	3 L of Coca-cola lavage	12 h
Chung et al[8]	Diospyrobezoars	1	Injection of 30 mL of Coca-cola and drinking 4 L of Coca-cola	2 d
Lin et al[9]	Diospyrobezoars	1	Injection and irrigation with 1 can of Coca-cola + oral drink of 1 can
Okamoto et al[10]	Diospyrobezoars	1	Drinking 500 mL of Coca-cola per day	7 d
Sechopoulos et al[11]	Stump of vegetables	1	2 cans of Coca-cola injection
Whitson et al[12]	Phytobezoar	1	Drinking 5 L of Coca-cola per day	5 d