Taha Qazi, MD: Glucagon for Esophageal Foreign Body Impactions

Although endoscopic removal is the procedure of choice for esophageal foreign body impaction (EFBI) and is successful in the majority of cases, several types of medical management have been studied for the management of EFBI.

Glucagon is frequently used for the relief of esophageal impactions, as it decreases the lower esophageal sphincter tone through smooth muscle relaxation, increasing peristalsis and improving transit time. However, research about its use for food disimpaction is limited, something a recent double-blind, multicenter randomized controlled trial sought to address.

The sixth issue of Qazi Corner, a collaborative quarterly newsletter on gastroenterology research, news, and trends between HCPLive and editor-in-chief Taha Qazi, MD, highlights recent research about the use of glucagon versus placebo for the resolution of alimentary esophageal impaction. Conducted at 4 centers from April 2020 to March 2023, the study ultimately found glucagon did not significantly impact EFBI resolution, time of endoscopy, or extraction length.

“The study was a negative study, meaning that even though we do this practice really commonly where we provide patients with glucagon when they come to the hospital for esophageal impaction, which can be a very debilitating situation, that glucagon doesn’t tend to work to relieve impaction in any way,” Qazi, a gastroenterologist with the Cleveland Clinic, explained to HCPLive.

Investigators noted future studies powered for the subgroup analysis of different esophageal diseases could be useful to explore the use of glucagon in other contexts outside of esophageal impaction where it may have a greater benefit.

Still, Qazi highlighted the importance of the present study, even with its negative results, saying “It will likely allow us to come in sooner to get these procedures done and more importantly prevent delays as it relates to providing patients with medications that are likely not going to be that effective in the management of esophageal impaction.”