Cola Treatment for a Gastric Bezoar: When Soda Became Medicine

Cola treatment for a gastric bezoar became part of the care of a 63-year-old woman who had endured a month of worsening nausea, vomiting, and abdominal pain. Doctors found a dense mass of undigested food in her stomach. After two days of diet cola, a repeat endoscopy could no longer find it.

That kind of mass is called a bezoar. It forms when food particles, often plant fibers, remain in the stomach, stick together, and gradually become compacted. A bezoar can cause early fullness, loss of appetite, pain, nausea, vomiting, and sometimes interfere with the normal passage of food.

During the previous year, the woman had lost 18 kilograms. Around the same time, she had started weekly semaglutide at a dose of 2 mg for type 2 diabetes and weight loss. A CT scan showed a moderately distended stomach filled with semisolid material, and an endoscopic examination confirmed the bezoar.

Why cola was used

Semaglutide was stopped when the patient was admitted. Rather than immediately breaking up the mass endoscopically or removing it surgically, the medical team first tried chemical dissolution with cola.

The original plan called for 3 liters over 12 hours. The patient disliked carbonated drinks and was reluctant to consume that much, so the regimen was changed to approximately 1.5 liters of diet cola per day. The sugar-free version was chosen because she had diabetes.

On the second day, she felt a sudden pulling sensation in her abdomen, followed by a rapid improvement in nausea and discomfort. A repeat endoscopy showed that the bezoar was no longer present. She returned to a regular diet and left the hospital without nausea, vomiting, or abdominal pain.

The examination could not establish that the mass had dissolved completely. It may have softened, fragmented, and passed farther through the digestive tract. Even so, the sequence illustrates why cola is sometimes used as a relatively simple first approach for food-based gastric bezoars in clinically stable patients.

The exact mechanism is uncertain. The drink’s acidity may help soften plant fibers, while carbonation and fluid penetration may contribute to breaking up the compact mass. Gastroenterologists have used this approach for years, but it does not work for every kind of bezoar and it is not a substitute for diagnosis.

Where semaglutide fits

Semaglutide mimics the effects of the hormone GLP-1. Along with reducing appetite and helping control blood glucose, it slows gastric emptying. Food remains in the stomach longer, which can prolong the feeling of fullness.

Most people taking semaglutide do not develop bezoars. However, marked slowing of stomach motility could, in principle, give food fibers more time to accumulate and compact.

Semaglutide was not the only plausible contributor in this case. The patient also used methadone long term and tramadol as needed. Opioids can also slow gastrointestinal motility, and the authors identified both semaglutide and opioid treatment as possible factors.

A planned gastric-emptying study was never completed after discharge. The clinicians therefore did not obtain direct evidence of severe gastroparesis, the condition in which the stomach empties abnormally slowly.

This was a report about one patient, not a study designed to measure risk. It cannot tell us how often bezoars occur in people taking semaglutide, and it does not prove that the drug was the sole cause. Drinking large amounts of cola is also not a safe do-it-yourself response to nausea or abdominal pain, which can signal many different conditions.

The broader lesson is more practical. Medicine sometimes uses an ordinary product not as food or drink, but as a tool with useful physical and chemical properties. A simple treatment still depends on getting the diagnosis right first.