Esophageal Food Impaction
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/17/2019 |
| Start Date: | August 25, 2017 |
| End Date: | June 10, 2019 |
| Contact: | Sam Stellpflug, MD |
| Email: | samuel.j.stellpflug@healthpartners.com |
| Phone: | 651-254-5304 |
Efficacy and Safety of Oral Nitroglycerin on Esophageal Food Impaction
This study is designed to obtain data on the safety and efficacy of oral nitroglycerin
solution for the treatment of esophageal food impaction in patients presenting to the
Emergency Department with presumed esophageal food impaction. The main hypothesis is to
determine the success rate of oral nitroglycerin solution in relieving the food impaction by
assessing the resolution of symptoms and the ability of the patient to swallow.
solution for the treatment of esophageal food impaction in patients presenting to the
Emergency Department with presumed esophageal food impaction. The main hypothesis is to
determine the success rate of oral nitroglycerin solution in relieving the food impaction by
assessing the resolution of symptoms and the ability of the patient to swallow.
A piece of food stuck in the esophagus (the tube connecting the mouth to the stomach) is a
relatively common occurrence, estimated at a rate of 13 episodes per 100,000 people per year,
mostly men, and usually attributed to swallowed meat. The current standard of care for
patients presenting to an Emergency Department with this problem includes a trial of
medication, usually glucagon but sometimes a carbonated beverage, an injection of
nitroglycerin, or benzodiazepines. The medical interventions mentioned above have not been
shown to be significantly effective and have unwanted side effects; glucagon is known to
cause nausea and vomiting and benzodiazepines can cause sedation and depressed breathing. If
the medication fails to relieve the problem, the patient may require a procedure called
endoscopy, where a video scope and retrieval tool are inserted into the esophagus to remove
the piece of food. There is significant risk associated with endoscopy, including the risks
of anesthesia as well as with the physical procedure itself. Endoscopy also results in a
prolonged hospital stay due to the time required for the procedure, as well as from
anesthesia recovery. The ideal treatment would be a safe, inexpensive, quickly effective
medication without significant side effects that could be administered without sedation or
extensive monitoring. Oral nitroglycerin solution might just be that intervention.
relatively common occurrence, estimated at a rate of 13 episodes per 100,000 people per year,
mostly men, and usually attributed to swallowed meat. The current standard of care for
patients presenting to an Emergency Department with this problem includes a trial of
medication, usually glucagon but sometimes a carbonated beverage, an injection of
nitroglycerin, or benzodiazepines. The medical interventions mentioned above have not been
shown to be significantly effective and have unwanted side effects; glucagon is known to
cause nausea and vomiting and benzodiazepines can cause sedation and depressed breathing. If
the medication fails to relieve the problem, the patient may require a procedure called
endoscopy, where a video scope and retrieval tool are inserted into the esophagus to remove
the piece of food. There is significant risk associated with endoscopy, including the risks
of anesthesia as well as with the physical procedure itself. Endoscopy also results in a
prolonged hospital stay due to the time required for the procedure, as well as from
anesthesia recovery. The ideal treatment would be a safe, inexpensive, quickly effective
medication without significant side effects that could be administered without sedation or
extensive monitoring. Oral nitroglycerin solution might just be that intervention.
Inclusion Criteria:
- Over the age of 18 years
- Presentation consistent with esophageal food impaction
- Ability to swallow a small volume of liquid.
Exclusion Criteria:
- Intractable vomiting
- Hemodynamic instability or SBP <100 mmHg
- Concern for or evidence of significant airway compromise
- Concern for or evidence of esophageal perforation,
- Concern for or evidence of coronary ischemia
- Presentation > 12 hours since onset.
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Regions Hospital Established in 1872, Regions Hospital is a private, not-for-profit organization. The hospital provides...
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