Social Media Trends, Dry Scooping, and Extensive Esophageal Ulcerations

• Published in: Journal of general internal medicine : JGIM Vol. 38; no. 16; pp. 3633 - 3635
• Main Authors: Caratenuto, Russell, Karanfilian, Briette, Navlani, Rishika, Dalal, Ishita, Sharma, Ranita, Dave, Payal
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2023; Springer Nature B.V
• Subjects: Amino acids; Caffeine; Cardiac arrhythmia; Clinical Vignette; Creatinine; Dietary supplements; Digital media; Dysphagia; Endoscopy; Esophagus; Etiology; Gastroesophageal reflux; Ingestion; Internal Medicine; Medicine; Medicine & Public Health; Proton pump inhibitors; Social networks; Supplements; Trends; Ulcers
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-023-08432-9

We describe a case of severe odynophagia and dysphagia caused by dry scooping of multi-ingredient pre-workout powder (MIPS) with diffuse esophageal ulcerations on upper endoscopy. Dry scooping refers to ingesting work out supplements without the recommended doses of solvent. This trend has been the subject of TikTok and other social media sites aimed at enhancing workout performance. While caustic ingestions leading to esophageal ulcers and strictures are well known, dry scooping ingestion of pre-workout powder as an etiology has not been described. Though caffeine may be the predominant content in such powders, the exact composition and ratios of other constituents, including amino acids, are less clear. Complete abstinence from ingestion of the pre-workout formulation and the use of a proton pump inhibitor therapy led to significant clinical and endoscopic recovery over a 4-week period. A thorough history of ingestions, including supplements, is critical when unraveling emerging etiologies of esophageal ulcerations.