The pressure effects of different commercially available beverages on food boluses in vitro

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LARYNGOLOGY

The pressure effects of different commercially available beverages on food boluses in vitro Yousef Ibrahim1   · Simon Browning1 Received: 22 July 2020 / Accepted: 29 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Purpose  Acute oesophageal food impaction is a common and potentially life-threatening condition. Effervescent agents have been used to manage these patients. To date, there have not been any studies comparing the differences in commercially available beverages in relieving food bolus impaction. The aim of this study was to design an in vitro system where the pressure changes generated by different commercially available beverages could be compared in the presence of different food items. Methods  A closed in vitro system was designed using a flask and manometer. Different food items [potato, beef, chicken, and no food item (control)] and different beverages (Coca-Cola®, lemonade, 7 Up Free, Prosecco and water) were inserted into this system in turn. For each food item and beverage, pressure changes ­(cmH2O) were recorded over a 3-min period. Results  Comparing the different food items, the potato appeared to cause the greatest increases in pressure over most time points with all beverages except Coca-Cola® and water. Between the beverages, the lemonade and Prosecco seemed to generate the greatest pressure changes; lemonade generating higher (but non-significant) pressures than the Prosecco with the potato and control. Conclusion  Our study demonstrates that, in vitro, amongst the beverages, lemonade and Prosecco generated the greatest increases in pressure, whilst potatoes generated a greater reaction than the other food items. These findings need to be studied in further detail and, if deemed clinically relevant, may prompt further investigation for their use in the clinical setting. Keywords  Food bolus · Oesophageal impaction · Beverages · In vitro techniques

Introduction Acute oesophageal food impaction is a common and potentially life-threatening condition. It has an estimated incidence rate of 13 per 100,000 and a male-to-female ratio of 1.7:1 [1]. This increased incidence may in part be due the increasing incidence of conditions such as eosinophilic oesophagitis [2]. Although a significant majority of foreign bodies may pass through the gastrointestinal tract spontaneously, around 10–20% will not [3]. The gold standard management of oesophageal food boluses remains an area of contention [4]. Although the use of endoscopy is a valuable tool in removing a bolus, it is not without its own risks. These include bleeding, dental injury, perforation, and rarely, mediastinitis [5]. * Yousef Ibrahim [email protected] 1



Department of Otolaryngology, Morriston Hospital, Swansea SA6 6NL, UK

Effervescent agents (EAs) have been suggested as an alternative management strategy [6]. The benefits may include earlier disimpaction, reduced hospital stay, and reduced costs [6]. A recent study by David et al. compared the use of EAs against glucagon. Prior to endos