Glucagon and Food bolus


This is a challenging question that always comes up in patients with food bolus. What evidence do we have to recommend Glucagon in this situation? is this another version of Kayexalate in case of hyperkalemia? ūüėČ Tibbling et al in Dysphagia 1995 described a multicenter, placebo-controlled, double-blind study of Glucagon and Diazepam vs placebo. They rejected¬† their hypothesis of muscle spasm as an important cause of esophageal obstruction but study was very small.¬† Sanjay Arora and Galich in CJEM, 2009 did a review of this topic and found “Glucagon is an effective first-line therapy for esophageal foreign body impaction” was a MYTH. Their conclusion was there is no clear evidence that glucagon¬† can help in bolus impaction and with regards to side effects of it, nausea, vomiting and risk of perforation and aspiration, we should consider other alternatives. Leopard et al, 2011, had another review on this topic and showed that Glucagon was not better than placebo. The whole idea comes from a theory that Glucagon decrease the¬†esophageal motor function in mid and distal portion. I should echo the messages of all these study that there is no clear data to show Glucagon is effective or safe, So, call your GI colleague!