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Cold Carbonated Drinks Can Potentially Damage The Oesophagus

Throwing back a 'cold one' may cause damage to the oesophagus in susceptible people, according to an article published in the current issue of the Medical Journal of Australia.

The authors, Dr Hui Jern Loh and Mr David Cooke from Fremantle Hospital, present a rare case in which the rapid ingestion of a mouthful of cold carbonated drink led to a tear in a woman's oesophageal wall.

The woman suffered sudden chest pain and a brief loss of consciousness immediately after swallowing a large mouthful of a cold carbonate drink directly from the bottle. The pain felt worse on swallowing. The patient suffered mild nausea but no vomiting. She had a slightly increased temperature (37.6C) and a slightly raised white blood cell count.

A CT scan revealed a tiny bubble of gas in or near the wall of the oesophagus, suggesting that the woman's oesophagus had been perforated. A gastroscopy revealed a 10 cm tear (a partial perforation) in her oesophagus.

The patient was treated with a range of drugs and was discharged from hospital on Day 7. After four weeks she still felt discomfort when swallowing, but the tear had healed.

Spontaneous oesophageal perforation (Boerhaave's syndrome) — usually caused by forceful vomiting — is relatively uncommon, but potentially fatal in people who have complete perforation.

"Among people who experience complete perforation, mortality is 13-25 per cent if treated within 24 hours of symptom onset . . . and 89 per cent if treated after more than 48 hours", say the authors.

People who suffer from a range of digestive problems, including reflux oesophagitis, infectious oesophagitis or Barrett's ulceration, are at greater risk of developing Boerhaave's syndrome.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT Dr Hui Jern LOH 0402 883 910

Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471

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