PB produced more short-chain fatty acids (SCFA) than BB in the ascending and descending colon but less in the transverse colon (p 0.05). Linear discriminant analysis effect size (LEfSe) shows supplement fed with PB enriched Clostridium and Citrobacter during colon fermentation using the Simulated Human Intestinal Microbial Ecosystem (SHIME), whereas BB differentially increased Megasphaera, Bacteroides, Alistipes, and Blautia at the genus level. The markedly different food structures result in significantly higher free fatty acid (FFA) bioaccessibility for PB (28.2 ± 4.80%) than BB (8.73 ± 0.52%) during simulated in-vitro digestion using the TIM Gastrointestinal Model-1 (TIM-1). Ultra-processed, plant-based burgers (PB) and traditional comminuted-beef burgers (BB) share similar organoleptic and most physicochemical properties, but PB does not contain intact whole food structures, while BB entraps lipids throughout their myofibrillar protein network. A knowledge gap exists in understanding the role of food structure on lipid digestion and colonic fermentation of formulated foods compared to the whole food they seek to emulate. Ultra-processed foods (UPFs) formulated from highly refined ingredients are not simply a sum of their macronutrients composition alone cannot explain the association between high UPFs intake and increased malnutrition risks (i.e., obesity, metabolic syndrome). This review provides evidence-based recommendations concerning these conditions, focusing on evaluation and management.Ĭomplete obstruction endoscopy esophageal foreign body food bolus impaction.Digestive Fate of Ultra-Processed Foods: From Bolus to Stool Early endoscopy for complete obstruction is associated with improved outcomes. Endoscopy is the intervention of choice, and medications should not delay endoscopy. Before administration, shared decision making with the patient is recommended. Medications evaluated include effervescent agents, glucagon, calcium channel blockers, benzodiazepines, nitrates, and others, but their efficacy is poor. Management requires initial assessment of the patient's airway. Computed tomography is recommended if radiograph is limited or there are concerns for perforation. The preferred test is a plain chest radiograph, although this is not required if the clinician suspects non-bony food bolus with no suspicion of perforation. Diagnosis is based on history and examination, with most patients presenting with choking/gagging, vomiting, and dysphagia/odynophagia. Foreign body obstruction and food bolus impaction typically occur at sites of narrowing due to underlying esophageal pathology. Pediatric patients are the most common population affected, while in adults, edentulous patients are at greatest risk. This narrative review provides evidence-based recommendations for the assessment and management of patients with esophageal foreign bodies and food bolus impactions.Įsophageal foreign bodies and food bolus impaction are common but typically pass spontaneously however, complete obstruction can lead to inability to tolerate secretions, airway compromise, and death. There is a dearth of emergency medicine-focused literature concerning these conditions. Patients with esophageal foreign bodies or food bolus impaction may present to the emergency department with symptoms ranging from mild discomfort to severe distress.
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