GLP‑1 drug’s rare gastric obstruction dissolved with Diet Coke

A case study in the New England Journal of Medicine, as reported by Ars Technica, highlights a rare side effect of GLP‑1 therapy—formation of a gastric bezoar—successfully treated with diet cola.

In the case, a 63‑year‑old patient taking semaglutide for weight loss presented with severe abdominal pain, persistent nausea, and vomiting. Imaging and endoscopy revealed a large, mucus‑coated mass occupying the stomach called a phytobezoar. GLP‑1 drugs are known to slow gastric emptying, which can create conditions for indigestible plant fibers to clump and harden into bezoars.

Rather than surgery or endoscopic fragmentation, doctors tried first‑line chemical dissolution using Coca-Cola, because carbonic and phosphoric acids can help break down fibrous material. Given the patient’s type 2 diabetes, physicians opted for Diet Coke. After consuming a reduced volume, about four cans over 12 hours, the patient reported rapid symptom relief, and a follow‑up endoscopy confirmed the bezoar had dissolved.