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Aliment Pharmacol Ther. 2013 Jan;37(2):169-73. doi: 10.1111/apt.12141.

Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment.

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Gastroenterology Division, First Department of Medicine - Propaedeutic, Medical School, Athens University, Laikon Hospital, Athens, Greece.



Gastric phytobezoars represent the most common bezoars in patients with poor gastric motility. A variety of dissolution therapies and endoscopic fragmentation techniques have been evaluated as conservative treatment so as to avoid surgery.


To investigate the effectiveness of Coca-Cola for gastric phytobezoars dissolution.


We performed a systematic search to identify publications on gastric phytobezoars to assess the efficacy of Coca-Cola as a dissolution therapy. Diospyrobezoars, formed after persimmon ingestion, are a distinct type of phytobezoars characterized by their hard consistency. Thus, these two subgroups of bezoars were compared in terms of successful dissolution.


Over a 10-year period (2002-2012), 24 papers including 46 patients have been published. In 91.3% of the cases, phytobezoar resolution with Coca-Cola administration was successful, either as a single treatment (50%) or combined with further endoscopic techniques, whereas only 4 patients underwent surgery. Phytobezoars were more likely to dissolve after initial attempt with Coca-Cola compared with diospyrobezoars (60.6% vs. 23%, P = 0.022).


Coca-Cola alone is effective in gastric phytobezoar dissolution in half of the cases and, combined with additional endoscopic methods, is successful in more than 90% of them.

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