1
|
Caratenuto R, Karanfilian B, Navlani R, Dalal I, Sharma R, Dave P. Social Media Trends, Dry Scooping, and Extensive Esophageal Ulcerations. J Gen Intern Med 2023; 38:3633-3635. [PMID: 37758968 PMCID: PMC10713499 DOI: 10.1007/s11606-023-08432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
We describe a case of severe odynophagia and dysphagia caused by dry scooping of multi-ingredient pre-workout powder (MIPS) with diffuse esophageal ulcerations on upper endoscopy. Dry scooping refers to ingesting work out supplements without the recommended doses of solvent. This trend has been the subject of TikTok and other social media sites aimed at enhancing workout performance. While caustic ingestions leading to esophageal ulcers and strictures are well known, dry scooping ingestion of pre-workout powder as an etiology has not been described. Though caffeine may be the predominant content in such powders, the exact composition and ratios of other constituents, including amino acids, are less clear. Complete abstinence from ingestion of the pre-workout formulation and the use of a proton pump inhibitor therapy led to significant clinical and endoscopic recovery over a 4-week period. A thorough history of ingestions, including supplements, is critical when unraveling emerging etiologies of esophageal ulcerations.
Collapse
Affiliation(s)
| | | | - Rishika Navlani
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ishita Dalal
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ranita Sharma
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Payal Dave
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| |
Collapse
|
2
|
Sur LM, Armat I, Sur G, Tisa IB, Bordea MA, Lupan I, Samasca G, Lazar C. Practical Aspects of Upper Gastrointestinal Bleeding in Children. J Clin Med 2023; 12:jcm12082921. [PMID: 37109257 PMCID: PMC10145382 DOI: 10.3390/jcm12082921] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/01/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Upper gastrointestinal bleeding (UGB) in children is a potentially life-threatening condition that represents a challenge for pediatricians and pediatric surgeons. It is defined as bleeding from any location within the upper esophagus to the ligament of Treitz. UGB can have many causes that vary with age. The impact on the child is often proportional to the amount of blood lost. This can range from mild bleeding that is unlikely to cause hemodynamic instability, to massive bleeding that requires admission to the intensive care unit. Proper and prompt management are very important factors in reducing morbidity and mortality. This article aims to summarize current research regarding the diagnosis and treatment of UGB. Most of the data used in the literature published on this subject is extrapolated from adulthood.
Collapse
Affiliation(s)
- Lucia Maria Sur
- Department of Pediatrics I, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Ionel Armat
- Department of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Genel Sur
- Department of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Ioana Badiu Tisa
- Department of Pediatrics III, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Madalina Adriana Bordea
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Iulia Lupan
- Department of Molecular Biology, Babes Bolyai University, 400084 Cluj-Napoca, Romania
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Calin Lazar
- Department of Pediatrics I, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| |
Collapse
|
3
|
Arhinful JS, Arhinful B, Akins TA, Hossain S. Caffeine-Induced Severe Erosive Esophagitis. Cureus 2021; 13:e16253. [PMID: 34373814 PMCID: PMC8346271 DOI: 10.7759/cureus.16253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Caffeine is one of the most frequently used stimulants worldwide. It is, therefore, subject to frequent intentional and unintentional misuse. However, severe erosive esophagitis due to acute caffeine overdose is extremely rare. We report the case of a 43-year-old male with a past medical history of paranoid schizophrenia admitted to our hospital with esophageal symptoms (throat pain, retrosternal chest pain, dysphagia/odynophagia, nausea, and vomiting) two days after ingesting a bottle of caffeine pills containing about 30 g of caffeine in a suicide attempt. He was found to have rhabdomyolysis and acute renal failure warranting hemodialysis. Esophagogastroduodenoscopy done due to persistent retrosternal chest pain, dysphagia, odynophagia, and nausea despite being on oral famotidine 20 mg daily revealed severe erosive esophagitis. This case highlights the risk of concurrent renal and gastrointestinal injuries after acute ingestion of an excessive amount of caffeine tablets. Our experience suggests that in patients of caffeine overdose with persistent esophageal symptoms such as odynophagia, dysphagia, and retrosternal chest pain, endoscopic evaluation is advisable to rule out drug-induced esophagitis.
Collapse
Affiliation(s)
- Justice S Arhinful
- Internal Medicine, University of Missouri School of Medicine, Springfield Clinical Campus, Springfield, USA.,Hospital Medicine/Internal Medicine, Lester E. Cox Medical Center South, Springfield, USA
| | - Benedicta Arhinful
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Timi A Akins
- Nephrology, Ferrell-Duncan Clinic, Springfield, USA
| | - Sarah Hossain
- Gastroenterology, Ferrell-Duncan Clinic, Springfield, USA
| |
Collapse
|
4
|
de Sousa LN, Sant'ana DSP, Siqueira dos Santos RG, dos Santos Ribeiro AEA, da Costa CF, de Oliveira AP, Almeida JRGDS, Jucá DM, da Silva MTB, dos Santos AA, Palheta Junior RC. Involvement of serotonergic pathways in gastric dysmotility induced by fat burning nutritional supplements in mice. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2021; 2:100018. [PMID: 34909653 PMCID: PMC8663933 DOI: 10.1016/j.crphar.2021.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022] Open
Abstract
Fat burners are a category of nutritional supplements that are claimed to increase the metabolism and promote greater energy expenditure, leading to weight loss. However, little is known about the side effects on gastrointestinal motility. In this study, we evaluated the effect of ingestion with a fat burner named Thermbuterol® (THERM) on the gastric motility and food behavior of mice. THERM compounds were identified using nuclear magnetic resonance (NMR). Mice received variable doses of THERM (10, 50, 100 or 300 mg/kg, p.o.) or NaCl 0.15 M (control). Gastric emptying (GE) was assessed using the phenol red technique. Another set of mice was pretreated with intraperitoneal administration of hexamethonium (HEXA, 10 mg/kg), prazosin (PRAZ, 0.25 mg/kg), propranolol (PROP, 2 mg/kg), parachlorophenylalanine (PCPA, 300 mg/kg) or ondansetron (ONDA, 50 μg/kg) 30 min before THERM treatment for evaluation of GE. We assessed the gastrointestinal responsiveness in vitro as well as THERM's effects on food behavior. Caffeine was the major compound of THERM, identified by NMR. THERM 100 and 300 mg/kg decreased GE compared to the respective controls. Pretreatment with PRAZ or PROP did not prevent gastric dysmotility induced by THERM 100 mg/kg. However, the pretreatment with HEXA, ONDA or PCPA prevented GE delay induced by THERM. In vitro, THERM relaxed contractions in strips of longitudinal gastric fundus and duodenum. THERM also increased food intake, which was prevented by PCPA and ONDA treatments. THERM decreased GE of a liquid and increased food intake in mice, a phenomenon mediated by the autonomic nicotinic receptors and serotoninergic receptor.
Collapse
Affiliation(s)
| | | | | | | | - Camila F. da Costa
- Federal University of São Francisco Valley, Petrolina, Pernambuco, Brazil
| | | | | | - Davi M. Jucá
- Belo Horizonte University Center, Cristiano Machado Campus. Belo Horizonte, Minas Gerais, Brazil
| | - Moisés Tolentino Bento da Silva
- Laboratory of Exercise and Gastrointestinal Tract – Department of Physical Education, Federal University of Piauí, Teresina, Piauí, Brazil
| | - Armênio A. dos Santos
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | |
Collapse
|