TWO SUCCESSFUL CASES OF DISSOLUTION THERAPY WITH CARBONATED WATER FOR GASTRIC PHYTOBEZOARS

Abstract

It has been reported that dissolution with Coca-Cola or carbonated drinks may be useful for treating gastric phytobezoars. However, its mechanism has not been clarified yet. We hypothesize that the effectiveness of dissolution therapy is mediated through the air bubbles of carbon dioxide. Here we report two successfully treated cases of gastric phytobezoars using dissolution therapy with carbonated water administration and endoscopic fragmentation. The patients were a 91-year-old woman and a 79-year-old woman, having a 5 cm phytobezoar and a 4 cm phytobezoar with gastric ulcer, respectively, both revealed by upper gastrointestinal endoscopy. After they received 2000 ml per day of carbonated water through a nasogastric tube for 3 days, the bezoars that had been resistant to endoscopic therapy were softened and easily destroyed by endoscopic treatment.