Use of glucagon and gas-forming agents in acute esophageal food impaction.

Smith, John W.; Janower, Murray L.; Geiger, A H

doi:10.1148/radiology.159.2.3083481

Cited by 14 publications

(3 citation statements)

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“…Glucagon has been used successfully in promoting the passage of meat boluses since first described by Ferrucci and Lung [30] and is thought to work by reducing lower oesophageal sphincter pressure [31].…”

Section: Discussionmentioning

confidence: 99%

Oesophageal Foreign Bodies: Pattern and Management in a Tertiary Health Facility of a Developing Country

Nwosu

Chime

Okechi

2018

JAMMR

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Section: Discussionmentioning

confidence: 99%

Oesophageal Foreign Bodies: Pattern and Management in a Tertiary Health Facility of a Developing Country

Nwosu

Chime

Okechi

2018

JAMMR

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“…However, due to the variable results, some investigators have combined glucagon with gas-forming agents. A solution of tartaric acid is usually used, followed immediately by a solution of sodium bicarbonate, which produces carbon dioxide in the esophagus that helps to push the food bolus into the stomach [26][27][28]. Despite the hope to increase the success rate of esophageal food disimpaction with the combination therapy, results remained inconsistent [26].…”

Section: Discussionmentioning

confidence: 99%

Effect of Doses of Glucagon Used to Treat Food Impaction on Esophageal Motor Function of Normal Subjects

et al. 1999

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We studied 10 normal subjects to determine the effect of doses of intravenous glucagon used to treat food impaction on esophageal motor function. With a multilumen assembly perfused by a low compliance pneumohydraulic infusion pump, esophageal manometry was performed during baseline and after randomized administration of 0. 25, 0.5, and 1 mg intravenous glucagon. Mean proximal and distal amplitudes of contraction, proximal and distal amplitude of contraction duration, lower esophageal sphincter (LES) resting pressure, percentage of LES relaxation, and glucagon-related side effects were evaluated. No effect on proximal amplitude of contraction and proximal or distal esophageal contraction duration was noted. Mean amplitude of contraction in the distal esophagus was further reduced with increased dosage of glucagon but did not achieve statistical significance. Mean LES resting pressure was significantly reduced after 0.25 mg (18.7 +/- 1.8 vs. 10.2 +/- 1.5 mmHg, p = 0.0001) and further reduced after 0.5 mg (5.9 +/- 1.2 mmHg, p = 0.0009). Mean LES relaxation was significantly reduced after 0. 25 mg (93.1 +/- 2.4% vs. 63.6 +/- 8.8%, p = 0.0031). The 1-mg dose versus the 0.5-mg did not provide further reduction in any LES function parameters. One subject experienced transient nausea after 0.5 mg, and 4 subjects experienced nausea after 1 mg glucagon. In conclusion, increased doses of glucagon further reduce mean distal esophageal amplitude of contraction. Although maximum reduction in mean LES resting pressure was achieved with 0.5 mg, it did not provide any potential therapeutic advantage over 0.25 mg glucagon. Nausea is a common, transient side effect predominantly affecting subjects treated with the 1-mg dose.

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“…Carbonated beverages are used with the theoretical mechanism of carbon dioxide gas release that distend the lumen and act as a piston to push the object from the esophagus into the stomach, however the effectiveness of this method is unreliable and anecdotal perforations have been reported. 48 , 49 Papain, a meat tenderizer is not recommended due to the lack of efficacy and risk of perforation and mediastinitis. 50 Interventional radiographic methods, such as the use of a Foley catheter to extract FB or impacted food bolus are not recommended unless flexible endoscopy is not available.…”

Section: Endoscopic Managementmentioning

confidence: 99%

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

Magalhães-Costa

Carvalho

Rodrigues

et al. 2016

GE Portuguese Journal of Gastroenterology

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Gastrointestinal foreign bodies (FB) are comprised of food bolus impaction and intentionally or unintentionally ingested or inserted true FB. Food bolus impaction and true FB ingestion represent a recurrent problem and a true challenge in gastrointestinal endoscopy. More than 80–90% of the ingested true FB will pass spontaneously through the gastrointestinal tract without complications. However, in 10–20% of the cases an endoscopic intervention is deemed necessary. True FB ingestion has its greatest incidence in children, psychiatric patients and prisoners. On the other hand, food bolus impaction typically occurs in the elderly population with an underlying esophageal pathology. The most serious situations, with higher rates of complications, are associated with prolonged esophageal impaction, ingestion of sharp and long objects, button batteries and magnets. Physicians should recognize early alarm symptoms, such as complete dysphagia, distressed patients not able to manage secretions, or clinical signs of perforation. Although many papers are yearly published regarding this subject, our knowledge is mainly based on case-reports and retrospective series. Herein, the authors summarize the existing evidence and propose an algorithm for the best approach to FB ingestion.

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Use of glucagon and gas-forming agents in acute esophageal food impaction.

Cited by 14 publications

References 0 publications

Oesophageal Foreign Bodies: Pattern and Management in a Tertiary Health Facility of a Developing Country

Oesophageal Foreign Bodies: Pattern and Management in a Tertiary Health Facility of a Developing Country

Effect of Doses of Glucagon Used to Treat Food Impaction on Esophageal Motor Function of Normal Subjects

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

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