Glucagon for Esophageal Obstruction

Glucagon has been proposed as a treatment for esophageal obstruction, particularly in cases of food bolus impaction, due to its ability to relax smooth muscle and reduce lower esophageal sphincter (LES) tone. However, its effectiveness remains questionable and is not strongly supported by the literature. 

Systematic reviews and meta-analyses suggest that glucagon does not significantly improve treatment success compared to placebo and may be associated with an increased risk of adverse effects, such as nausea and vomiting, which can further complicate airway management and increase aspiration risk (Long & Gottlieb, 2020). Furthermore, a comprehensive review of available treatments for esophageal obstruction concluded that there is no strong evidence supporting glucagon over conservative management strategies such as a “watch and wait” approach to facilitate bolus passage (Leopard et al., 2011).

Ultimately, endoscopic intervention remains the gold standard for persistent esophageal obstruction and is the preferred approach when conservative measures fail. Given the inconsistent efficacy and potential risks associated with glucagon, its routine use for esophageal obstruction should be reconsidered in favor of more evidence-based interventions (Long & Gottlieb, 2020).