Buscopan in oesophageal food bolus: is it really effective?

Food bolus (FB) impaction of the oesophagus is one of the more common emergencies in otolaryngology. These patients are managed either conservatively or surgically. The guideline of the American Society of Gastrointestinal Endoscopy (ASGE) suggests that conservative management either with pharmacological agents or with an effervescent agent should be tried for 24 h usually prior to surgical intervention. Various pharmacological agents have been used to dislodge food bolus with varying success rates. We currently use buscopan as a pharmacological agent to dislodge obstruction. Our objective was to evaluate the efficacy of buscopan in the management of oesophageal food bolus. Dislodgement of food bolus and avoidance of oesophagoscopy were taken as a measure of the effectiveness of buscopan. There is no clear evidence in the literature for the time taken for spontaneous dislodgement or the proportion of cases needing oesophagoscopy. Reviewing the results in the last 5 years in our department, we found that food bolus obstruction was relieved in 68% of the patients who had buscopan and in 63% who did not have buscopan. There was no statistically significant difference in both groups (P=0.37).