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Is buscopan effective in meat bolus obstruction?
Summary
Hyoscine butyl bromide (buscopan) showed an 82% success rate in relieving oesophageal meat bolus obstruction. However, this study found no significant difference compared to no medication, suggesting a need to review its routine use.
Area of Science:
- Gastroenterology
- Emergency Medicine
- Pharmacology
Background:
- Oesophageal meat bolus obstruction is a common emergency.
- Hyoscine butyl bromide (buscopan) is frequently used to treat this condition.
- Evidence supporting its efficacy is limited.
Purpose of the Study:
- To assess the effectiveness of hyoscine butyl bromide (buscopan) in resolving oesophageal meat bolus obstructions.
- To compare outcomes between patients treated with buscopan and those who received no medication.
Main Methods:
- Retrospective review of 29 patients (31 episodes) presenting with oesophageal meat bolus obstruction.
- Inclusion criteria: adults with meat bolus obstruction, treated with either buscopan or no medication.
- Exclusion criteria: patients under 16, those receiving other medications, or with different obstructions.
Main Results:
- Buscopan relieved obstruction in 18 out of 22 episodes (82%).
- Seven out of nine episodes (78%) resolved spontaneously without medication.
- Fisher's exact test showed no statistically significant difference between the buscopan and no-medication groups.
Conclusions:
- The routine use of hyoscine butyl bromide for oesophageal obstruction, particularly in the upper two-thirds, warrants review.
- Lack of objective evidence and potential side-effects question its routine administration.
- Larger studies are needed to definitively establish efficacy.