Brief Answer:
your friend is needed to be hospitalized for further management..

Detailed Answer:
Hello XXXX, Welcome to HCM,

I've gone through your query and understand your concern for your friend..

Now this is a extremely lethal mixture that your friend had taken, I'm glad to hear that he's conscious and alert..

Ideally speaking, harpic is corrosive (hydrochloric acid), and vomiting after it's ingestion can cause potential damage to the food pipe as well as the lungs and respiratory passage..

In successive situation, it's very likely to have swelling and chemical burn through out the gastro-esophageal passage (severity depends upon the quantity of harpic mainly)..

Yes, all those pain, difficulty in swallowing, breathing are mainly due to the corrosive induced chemical burn and swelling..

Your friend should be hospitalized dear, because he needs to be monitored as well as investigated further before allowing anything per orally..acid and corrosive induced chemical burns are quite severe, and if not inspected and managed properly, it can cause potential lethal tear in the food pipe and stomach region..

He needs to be investigated by a Gastroenterologist initially superficial injuries of the oral cavity and later on for a detailed upper GI endoscopy to look for the extent of damage under direct visualization..in the meanwhile he should be given drugs to reduce swelling as well as fluids and nutrition intravenously..at the same time he needs to monitored to prevent any infection in the affected region..

All these should be done in a hospital settings and definitely not at home..

So please don't give him anything per orally now till he's clinically examined and declared fit for taking anything orally..

Please don't panic, already three days have passed, but do take him to your nearest Hospital/ER from where he'll be taken further admission in the in patient dept. for further management..

Let me know how he stays later on..

Let me know if your having any further queries..


Take Care of Your Friend..
Kind Regards

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Brief Answer:
follow as already advised along with the following advises..

Detailed Answer:
Dear XXXX, Welcome back,
Thanks for following up..

Yes, body has it's own healing mechanism too, and by virtue of it, after any insult to the body(physical, chemical, psychological etc.) it gradually starts the healing process..but there has to a borderline of threshold level depending on the type of the injury..

As I've already explained in my previous reply, corrosive injury causes immediate chemical burn and erosion through out Oro-esophago-gastric mucosa, which later on gets inflammed and with further time, it gets narrowed; blocked; or even fibrosed (shrunk and hardened) and/ torn in severe cases..

All those symptoms, he's experiencing, are due to the post burn and swelling along with neuro-muscular tissue damage through-out that affected area..

Please try to understand what I'm trying to make you understand here, all these are quite severe symptoms, and immediate intervention is required to achieve maximal benefit out of it, you've already lost 3 days..don't delay any more ..

Time is extremely precious here..as with time delay, chances of further complications can only increase..

Your friend is in immediate need of proper medical attention, so just take him to a proper hospital set-up for further hospitalization and course of management..

Remember, don't let him allow any thing per orally till further investigations and further clearance by the concerned Gastroenterologist.

Do Not Delay any more, as with further delay chances of complications will only increase..

Let me know how he stays in the due course..

Take Care
Kind Regards

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Brief Answer:
Read very carefully the below advises and discuss with the gastro-enterologist..

Detailed Answer:
Hello XXXX, Welcome back,

I'm glad that you've gone through the necessary process..you've uploaded the same report pages three times..

Now the most severe type of burn always happen to the organ part which is mostly exposed to the offending agent, i.e. the esophagus in this case(most notably the upper third), that's why it's affected maximum also..

First of all, request the Radiologist/concerned Gastro-enterologist to provide exact gradation for the burns of the esophagus (whether it's IIA or IIB or mixed, however apparently it's mixed, but i'm only viewing just some per-taken still images, so the exact gradation may vary depending on the live images and the concerned Gastro-enterologist who's performing it) .. the reason for this is, management steps vary as per the gradation..

Good to note that there's only Grade I burns over the stomach region..

Feeding is the biggest challenge in this scenario, there're several possibilities available in this regard :

First of all, the mostly affected esophagus has to be given rest and time to heal, for that Nothing per orally should be allowed for at least the next 10-14 days..

During this period, feeding should be continued either by a Naso-Jejunal tube(FREKA) put under vision by the Gastro-enterologist

or

by a Feeding Gastrostomy(PEG) tube, again to be done by the gastro-enterologist only

or

by a Feeding Jejunostomy tube, to be done by a GI-surgeon/Gastro-enterologist


The decision regarding which of these should be done, is entirely dependent upon the Gastro-enterologist..

After 10-14 days, again follow-up should be done to decide the further course of action and decision regarding starting some liquids as trial feeding in the first place..

If this goes well, then initially only liquid curd based diet to be started for several weeks (timings dependent on how you stay later on and how your body responds overall and if no complications)..

Later on if every thing goes well, semi-solid, bland diet should be started after few weeks and see how it's getting tolerated..

Life-long antacid/PPI support to be continued..

Life-Long Follow-up with the Gastro-enterologist will be required..

The First one month is most important phase(sp. 2nd week to 4th week) as this is the time when the stage of narrowing/stricture and later on fibrosis develops ..

Routine and serial interval check UGI-Endoscopy is required for fist 6 months(every monthly) then gradually interval can be prolonged depending on how you stay..

Healing is time-consuming and may take several months to years (there's no fixed time line, it simply depends from individual to individual)..

If all these maintained properly, and if there's no complications later on, then betterment definitely will be there..but a disciplinary and systematic approach is must in order to achieve this..

Hope You'll understand, and discuss and stay always in touch with your Gastro-enterologist..

Let me know how you stay later on, I'll be glad to guide you further..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Take Care
Kind Regards

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