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Han YJ, Roy S, Siau AMPL, Majid A. Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults-two case reports and a review of literature. J Eat Disord 2022; 10:157. [PMID: 36348449 PMCID: PMC9643985 DOI: 10.1186/s40337-022-00677-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Disordered eating behaviour including binge-eating often results in significant medical conditions, which are at times fatal. It can result in acute gastric dilatation which can lead to ischemic necrosis and stomach rupture. Dyspepsia and bloating are common symptoms following binge eating. Patients commonly use over-the-counter medications like sodium bicarbonate or home remedies for relief. However, in very rare, reported cases, sodium bicarbonate has been attributed to cause acute gastric dilatation and spontaneous gastric rupture instead. METHODS We report two cases of spontaneous gastric rupture following consumption of sodium bicarbonate containing antacids after a large meal, and a review of the literature of similar cases. RESULTS A total of 36 cases were identified. Approximately half of the cases (47.2%) were correlated with eating disorders, with higher prevalence in females (69%) and a very high mortality rate (41.6%). Amongst the 36 cases, sodium bicarbonate ingestion was associated with 10 cases. The lesser curvature (36.1%) and anterior wall (33.3%) are the most common sites of rupture. Associated causes include binge-eating, gas release from sodium bicarbonate, gastric content fermentation, proximal and distal outlet obstruction, and muscular atony. DISCUSSION Sudden distension and impaired emptying mechanism of the stomach is necessary for spontaneous gastric rupture to occur. Acute gastric dilatation with perforation requires definitive surgical management. There should be a low threshold of suspicion for patients presenting with severe abdominal pain and abdominal distension following an episode of binge-eating. There is a need for patient education around the use of over-the-counter medications or home remedies.
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Affiliation(s)
- You Jin Han
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia
| | - Susmit Roy
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia. .,Calvary Mater Hospital, Newcastle, Edith & Platt St, Waratah, Newcastle, NSW, 2298, Australia. .,University of Newcastle, Newcastle, Australia.
| | - Ashley Maria Pei Ling Siau
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia
| | - Adeeb Majid
- Calvary Mater Hospital, Newcastle, Edith & Platt St, Waratah, Newcastle, NSW, 2298, Australia
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Patiño-Gallegos JA, González-Urquijo M, Padilla-Armendáriz D, Leyva-Alvizo A. Spontaneous rupture of the stomach secondary to bicarbonate ingestion. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2021; 86:315-317. [PMID: 34210462 DOI: 10.1016/j.rgmxen.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 10/21/2022] Open
Affiliation(s)
- J A Patiño-Gallegos
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | - M González-Urquijo
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | - D Padilla-Armendáriz
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | - A Leyva-Alvizo
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
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The IL1β-HER2-CLDN18/CLDN4 axis mediates lung barrier damage in ARDS. Aging (Albany NY) 2020; 12:3249-3265. [PMID: 32065780 PMCID: PMC7066891 DOI: 10.18632/aging.102804] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/19/2020] [Indexed: 12/17/2022]
Abstract
Objective: The high mortality rate associated with acute respiratory distress syndrome (ARDS) is a major challenge for intensive care units. In the present study, we applied bioinformatics and animal models to identify core genes and potential corresponding pathways in ARDS. Results: Using bioinformatics analysis, IL-1β was identified as the core gene of ARDS. Cell experiments showed that up-regulation of IL-1β downregulates claudin18 to promote lung barrier function damage by regulating the IL-1β-HER2/HER3 axis, further promoting the development of ARDS. This was validated in the animal models. Conclusion: IL-1β promotes the development of ARDS by regulating the IL-1β-HER2/HER3 axis. These findings deepen the understanding of the pathological mechanisms of ARDS. Methods: Transcription data sets related to ARDS were subjected to differential expression gene analysis, functional enrichment analysis, and receiver operating characteristic curve analysis and, so as to identify core genes in ARDS. Cell experiments were used to further explore the effects of core genes on lung barrier function damage. Animal models were applied to validate the effects of core gene in mediating biological signal pathways in ARDS.
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Abstract
This report is related to the unusual case of an 11-year-old boy presenting with acute gastric dilatation after the intake of excessive food and carbonated beverages after a 12-hour fasting who died of complications of acute reperfusion syndrome after decompression of the stomach with gastrotomy. An enormously distended stomach was encountered without volvulus and obstruction in the operation. Autopsy and histological findings revealed a severely distended stomach, the walls of which were notably thin and displayed transmural necrosis. The reported case demonstrated that enormous food and beverage intake may cause acute gastric dilatation and gastric necrosis, and subsequently, sudden death may develop in children. The subject reported here is the youngest child in literature dying from acute gastric dilatation and necrosis without any underlying disorders and exposed to autopsy.
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Hughes A, Brown A, Valento M. Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion. West J Emerg Med 2016; 17:619-22. [PMID: 27625729 PMCID: PMC5017849 DOI: 10.5811/westjem2016.6.30713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/11/2016] [Accepted: 06/07/2016] [Indexed: 01/10/2023] Open
Abstract
Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.
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Affiliation(s)
- Adrienne Hughes
- University of Washington, Division of Emergency Medicine, Seattle, Washington
| | - Alisha Brown
- University of Washington, Division of Emergency Medicine, Seattle, Washington
| | - Matthew Valento
- University of Washington, Division of Emergency Medicine, Seattle, Washington
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Letale Magenruptur eines 5-jährigen Mädchens mit Rett-Syndrom. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/s00194-014-0944-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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7
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Al-Abri SA, Kearney T. Baking soda misuse as a home remedy: case experience of the California Poison Control System. J Clin Pharm Ther 2013; 39:73-7. [PMID: 24313600 DOI: 10.1111/jcpt.12113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 10/31/2013] [Indexed: 01/13/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Baking soda is a common household product promoted by the manufacturer as an antacid. It contains sodium bicarbonate and has the potential for significant toxicity when ingested in excessive amounts. Characterizing the patterns and outcomes from the misuse of baking soda as a home remedy can guide the clinical assessment and preventative counselling of patients at risk for use of this product. METHODS We conducted a retrospective review of all symptomatic cases involving ingestion and misuse of a baking soda powder product that were reported to the California Poison Control System between the years 2000 and 2012. RESULTS AND DISCUSSION Of the 192 cases we identified, 55·8% were female, ages ranged 2 months to 79 years, and the most common reasons for misuse included antacid (60·4%), 'beat a urine drug test' (11·5%) and treat a UTI (4·7%). Most cases (55·2%) had significant symptoms warranting a medical evaluation, whereas 12 patients required hospital admission developed either electrolyte imbalances, metabolic alkalosis or respiratory depression. WHAT IS NEW AND CONCLUSION Misuse of baking soda can result in serious electrolyte and acid/base imbalances. Patients at highest risk of toxicity may include those who chronically use an antacid, those who use the method to 'beat' urine drug screens, pregnant women and young children. Self-treatment with baking soda as a home remedy may also mask or delay medical care thereby complicating or exacerbating an existing medical problem. We suggest that healthcare providers counsel high-risk patients about the potential complications of misuse of baking soda as a home remedy.
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Affiliation(s)
- S A Al-Abri
- Medical Toxicology Fellow, California Poison Control System - San Francisco Division, University of California, San Francisco, CA, USA
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Al-Abri SA, Olson KR. Baking soda can settle the stomach but upset the heart: case files of the Medical Toxicology Fellowship at the University of California, San Francisco. J Med Toxicol 2013; 9:255-8. [PMID: 23591957 PMCID: PMC3770998 DOI: 10.1007/s13181-013-0300-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Suad A. Al-Abri
- California Poison Control System, San Francisco Division, University of California, San Francisco, UCSF Box 1369, San Francisco, CA 94143-1369 USA
| | - Kent R. Olson
- California Poison Control System, San Francisco Division, University of California, San Francisco, UCSF Box 1369, San Francisco, CA 94143-1369 USA
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John RS, Simoes S, Reddi AS. A patient with foot ulcer and severe metabolic alkalosis. Am J Emerg Med 2012; 30:260.e5-8. [DOI: 10.1016/j.ajem.2010.10.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 10/30/2010] [Indexed: 11/30/2022] Open
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Forslund T, Koistinen A, Anttinen J, Wagner B, Miettinen M. Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report. Clin Med Case Rep 2008; 1:83-7. [PMID: 24179353 PMCID: PMC3785353 DOI: 10.4137/ccrep.s888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.
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Affiliation(s)
- Terje Forslund
- Division of Nephrology, Department of Internal Medicine, Jyväskylä, Finland
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Ajbani K, Chansky ME, Baumann BM. Homespun remedy, homespun toxicity: baking soda ingestion for dyspepsia. J Emerg Med 2007; 40:e71-4. [PMID: 18164162 DOI: 10.1016/j.jemermed.2007.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2006] [Revised: 02/12/2007] [Accepted: 04/13/2007] [Indexed: 11/25/2022]
Abstract
A 68-year-old man presented to the Emergency Department with a severe metabolic alkalosis after ingesting large quantities of baking soda to treat his dyspepsia. His underlying pulmonary disease and a progressively worsening mental status necessitated intubation for respiratory failure. Laboratory studies revealed a hyponatremic, hypochloremic, hypokalemic metabolic alkalosis. The patient was successfully treated after cessation of the oral bicarbonate, initiation of intravenous hydration, and correction of electrolyte abnormalities.
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Affiliation(s)
- Keyur Ajbani
- Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, New Jersey 08103, USA
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Byard RW, Couper RT, Cohle S. Gastric distension, cerebral palsy and unexpected death. ACTA ACUST UNITED AC 2001; 8:81-5. [PMID: 16083676 DOI: 10.1054/jcfm.2001.0478] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Two cases of unexpected death from massive gastric dilatation in individuals with severe spastic quadraparesis aged 14 and 20 years, respectively, are reported. Spontaneous rupture of the stomach occurred in one case. Predisposing factors to gastric dilatation associated with cerebral palsy include autonomic neuropathy, neuromuscular incoordination, air swallowing and malposition of the stomach. Death may be due to compromise of respiratory function caused by lung compression by the dilated stomach, or to peritonitis with sepsis. Acute gastric dilatation, with or without rupture, should be considered a potential cause of unexpected death in individuals with severe mental and physical disabilities.
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Affiliation(s)
- R W Byard
- Forensic Science Centre & Child Protection Unit, Women's and Children's Hospital, Australia.
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13
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Abstract
A 5-year-old girl with spontaneous rupture of the stomach was treated successfully with excision of the ischemic edges of the perforation with primary repair. In this case, vigorous resistance against medical measurement resulted in rupture of the stomach, which was already distended with a large amount of fluid and air. The child survived following immediate surgical intervention and intensive postoperative care.
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Affiliation(s)
- W J Soong
- Children's Medical Center, Veterans General Hospital-Taipei, Taiwan, Republic of China
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Abstract
Sodium bicarbonate is an extremely well-known agent that historically has been used for a variety of medical conditions. Despite the widespread use of oral bicarbonate, little documented toxicity has occurred, and the emergency medicine literature contains no reports of toxicity caused by the ingestion of baking soda. Risks of acute and chronic oral bicarbonate ingestion include metabolic alkalosis, hypernatremia, hypertension, gastric rupture, hyporeninemia, hypokalemia, hypochloremia, intravascular volume depletion, and urinary alkalinization. Abrupt cessation of chronic excessive bicarbonate ingestion may result in hyperkalemia, hypoaldosteronism, volume contraction, and disruption of calcium and phosphorus metabolism. The case of a patient with three hospital admissions in 4 months, all the result of excessive oral intake of bicarbonate for symptomatic relief of dyspepsia is reported. Evaluation and treatment of patients with acute bicarbonate ingestion is discussed.
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Affiliation(s)
- S H Thomas
- Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354
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15
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Connelly KP, Shropshire LC, Salzberg A. Gastric rupture associated with prolonged crying in a newborn undergoing circumcision. Clin Pediatr (Phila) 1992; 31:560-1. [PMID: 1468175 DOI: 10.1177/000992289203100910] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Gastrointestinal drugs. ACTA ACUST UNITED AC 1988. [DOI: 10.1016/s0378-6080(88)80103-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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