Delgado Galan M, Rabago LR. Has Coca-Cola treatment become the first-line therapy for gastric bezoars, both in general and specifically for western countries? World J Gastrointest Endosc 2024; 16(5): 237-243 [PMID: 38813574 DOI: 10.4253/wjge.v16.i5.237]
Corresponding Author of This Article
Luis Ramon Rabago, MD, PhD, Chief Physician, Department of Gastroenterology, Hospital San Rafael, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. May 16, 2024; 16(5): 237-243 Published online May 16, 2024. doi: 10.4253/wjge.v16.i5.237
Has Coca-Cola treatment become the first-line therapy for gastric bezoars, both in general and specifically for western countries?
Maria Delgado Galan, Luis Ramon Rabago
Maria Delgado Galan, Department of Gastroenterology, Hospital Severo Ochoa, Leganes 28914, Spain
Luis Ramon Rabago, Department of Gastroenterology, Hospital San Rafael, Madrid 28016, Spain
Co-first authors: Maria Delgado Galan and Luis Ramon Rabago.
Author contributions: Delgado Galan M conducted the literature review on the topic, while Rabago LR concentrated on the critical analysis of the randomized trial's discussion and conclusion.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Luis Ramon Rabago, MD, PhD, Chief Physician, Department of Gastroenterology, Hospital San Rafael, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Received: March 19, 2024 Revised: April 10, 2024 Accepted: April 29, 2024 Published online: May 16, 2024 Processing time: 55 Days and 7.3 Hours
Abstract
Phytobezoars is a rare disease and less common in Western countries. The stomach is the primary site for these formations, and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach. However, medical treatments using enzymatic and chemical agents, such as cellulase and Coca-Cola, aimed at dissolving the bezoars, have also been utilized, showing varying degrees of resolution success. Notably, the oral dissolution treatment with Coca-Cola has emerged as a promising, simpler, and more cost-effective method. The study by Liu et al represents an important step in clinical research on this topic, despite some limitations that need addressing for a more comprehensive understanding of its findings. Key considerations for future research include sample size calculation, endoscopic procedure details, outpatient vs. inpatient treatment, and detailed cost calculations. The study's exclusions, such as patients with upper gastric surgery, phytobezoars older than 14 d, and cases of gastroparesis, limit its applicability to broader populations, especially in Western countries. Given the promising outcomes of the Coca-Cola treatment, it's advocated as a first-line therapy for phytobezoars. Nonetheless, further research is essential to overcome these limitations. However special situations such as perforation or small bowel obstruction will require surgical treatment.
Core Tip: The study by Liu et al, is a prospective randomized study about the treatment of gastric phytobezoars through daily intake of Coca-Cola vs endoscopic treatment, and represents an important step in clinical research on this topic. Given the promising outcomes of the Coca-Cola treatment observed in this study, which demonstrated a 100% success rate in dissolving phytobezoars and showed reduced costs and occurrence of gastric ulcers, it is recommended as a primary treatment option for phytobezoars. The study's exclusions, such as patients with upper gastric surgery, phytobezoars older than 14 d, and cases of gastroparesis, limit its applicability to broader populations, especially in Western countries.
