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.