Effect of Coca-Cola on the Dissolution of Persimmon-Related Phytobezoar in a Tertiary Care Hospital

Abstract

Introduction Bezoars, masses of indigestible foreign bodies formed in the gastrointestinal tract, pose challenges in their management. Phytobezoars are particularly problematic due to their difficult diagnosis and resilience towards treatment. Recently, Coca-Cola has emerged as a potential solution due to its acidic composition and mucolytic properties. However, existing evidence is limited, highlighting the need for comprehensive studies. This research explores the efficacy of Coca-Cola in dissolving persimmon-related phytobezoars, aiming to contribute valuable insights to non-invasive treatment options. Material and methods Conducted as a descriptive case series, this study employed gastric cola lavage using non-probability purposive sampling. Patients aged 18-70 with persimmon-related phytobezoars were included. Two nasogastric tubes were inserted for cola lavage over 12 hours, utilizing three liters of cola until the disappearance of symptoms. When the bezoar disappeared, it was considered as complete success to the treatment. Results Out of 31 patients, 45.2% were male and 54.8% were female, with a mean age of 56.77 ± 9.01 years. Efficacy was noted in 54.8% of cases. Age less than 50 and no history of diabetes mellitus were associated with higher chances of treatment success (p-value ≤0.05). Conclusion Ingestion of Coca-Cola was highly effective, safe, and reliable for the dissolution of persimmon-related phytobezoars, as the frequency of efficacy was high in our study. Coca-Cola ingestion is a non-invasive and cost-effective mode of phytobezoar dissolution that should be taken as a first-line initial treatment option to attain desired outcomes.

Keywords: bezoars; coca–cola; diospyrobezoars; efficacy; gastric bezoars; gastric lavage; persimmon; phytobezoar.

Figure 1. Erect abdomen x-ray (A) shows a shadow in the stomach (black arrows) and distended distal bowel; CT scan (B) shows a characteristic mottled appearance in the stomach; barium meal shows filling defect (C); and barium meal shows no filling defect and free passage of contrast in distal bowel (D) in a patient diagnosed with gastric outlet obstruction secondary to persimmon-related gastric phytobezoar before (A)-(C) and after (D) intervention.

CT: computed tomography.

Figure 2. Erect abdomen X-ray showing ambiguous shadow (A) in the epigastrium and left hypochondrium (white arrow), barium meal (B); showing a filling defect in the gastric region, CT-scan (C); showing typical mottled appearance, and X-ray erect abdomen showing no significant findings (D) in a patient diagnosed with persimmon-related phytobezoar before (A)-(C) and after (D) intervention.

CT: computed tomography.