Vincent DeRosa, MD
Santa Barbara, California
Vincent DeRosa, MD, Judy Corliss, MSN, RN, Jeanne Li, MA, Cathy Cleek, BSN, RN, Catelynn Kenner, MPH
Santa Barbara Cottage Hospital, Santa Barbara, CA
Introduction: Esophageal food bolus obstruction is a common GI emergency without effective medical therapy, often requiring costly emergent endoscopy (EGD) for food bolus clearance. This case-control study compared the efficacy of standard of care treatment with the use of effervescent granules (sodium bicarbonate, citric acid, simethicone) for the treatment of esophageal food bolus obstructions.
Methods: Adult patients were recruited from three emergency rooms in a community-based, regional hospital system. A retrospective cohort treated with the standard of care, consisting of glucagon and/or lorazepam and/or IV fluids, was compared with a prospective cohort treated with effervescent granules. The primary end point was efficacy between the two treatment groups.
Results: From January 2018 – August 2018, 21 patients met the inclusion criteria for the retrospective arm and were treated with the standard of care; from September 2018- April 2019, 33 patients met the inclusion criteria and were treated with effervescent granules for esophageal food bolus obstructions. 3 out of 21 patients from the retrospective arm and 20 out of 33 patients from the prospective arm had successful food bolus clearance without requiring an EGD (success rate = 14.3% vs. 60.6%; p = 0.002.) There was one complication of a Mallory-Weiss tear noted on endoscopy without clinical significance in a patient treated with effervescent granules. The percentage of males was slightly higher in the prospective arm (22 males, 66.7% vs. 10 males, 47.6%; p = 0.27), and patients were slightly younger in the prospective arm (mean = 55.8 years, standard deviation (SD) = 16.8 vs. mean = 64.6, SD = 20.4; p = 0.11.)
Discussion: Treatment of esophageal food bolus obstruction with effervescent granules is more efficacious than the standard of care, with no clinically significant complications. Effervescent granules should be further studied as a safe and effective medical treatment option for this common GI emergency.
Citation: Vincent DeRosa, MD, Judy Corliss, MSN, RN, Jeanne Li, MA, Cathy Cleek, BSN, RN, Catelynn Kenner, MPH. P1181 - EFFERVESCENT GRANULES FOR THE TREATMENT OF ESOPHAGEAL FOOD BOLUS OBSTRUCTION. Program No. P1181. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.