What Are Bezoars and How Are They Dissolved or Removed?

Bezoars are tightly packed masses of food or other material that are found in the gastrointestinal tract, especially the stomach. They can be asymptomatic (causing no symptoms) or cause gastrointestinal symptoms like abdominal pain and bloating. Treatment of bezoars involves dissolving or removing the bezoar through various techniques.

Who Gets Bezoars?

Bezoars are a rare gastrointestinal condition that can occur in anyone. While they are sometimes called bezoar stones, their composition varies. They are made of partially digested or undigested material that can include food or nonfood items, such as hair.

People who are more likely to develop a bezoar are:

• People who are postoperative from stomach surgery
• People with psychiatric conditions that include chewing hair
• Infants who drink milk
• People who excessively consume persimmons
• People with delayed gastric emptying (gastroparesis)
• People of advanced age

Formation and Composition

Types of bezoars, how they form, and their composition include:

• Phytobezoars are the most common type of bezoar. They are made of undigested foods like fruit peels and seeds. This type of bezoar tends to occur in people who have had stomach surgery, such as gastric bypass or partial gastrectomy.
• Trichobezoars are bezoars made up of hair. This type of bezoar most commonly occurs in females with psychiatric conditions who chew and eat their hair.
• Lactobezoars are made of milk protein. They are typically seen in infants who are fed milk.
• Pharmacobezoars are made up of medications. This type is most common in people who take Carafate (sucralfate), which is often given for peptic ulcers, or aluminum hydroxide gel, which is an antacid.
• Diospyrobezoars can result from consuming a diet high in persimmon fruit, mainly in areas where the fruit is grown.

Associated GI Symptoms

Bezoars are typically asymptomatic. People who have them do not experience any signs or symptoms. However, symptoms can exist and may include:

• Abdominal pain
• Bloating
• Feeling full
• Weight loss

When to See a Provider

Even if you have mild symptoms of a bezoar, a healthcare provider should be consulted to evaluate your condition and make a diagnosis. A provider may recommend ways to dissolve the bezoar. If it cannot be dissolved, an endoscopic procedure or surgery may be needed to remove the lodged material.

Dissolving Bezoars at Home

People with mild bezoar symptoms may be able to treat it at home after consulting a healthcare provider. A healthcare provider may recommend drinking a carbonated cola beverage or taking cellulase (a digestive enzyme) to help break up and dissolve the bezoar.

Another option is the prescription medication Reglan (metoclopramide), which helps stimulate the stomach and intestines to promote gut movement.

Bezoar Endoscopic Removal

When a bezoar is large, is causing significant symptoms, or is unable to be dissolved, a healthcare provider might suggest using endoscopy to remove it. In endoscopy, a thin device called an endoscope, with a camera and tools attached, is inserted in the mouth, down through the esophagus (food tube), and into the stomach.

Endoscopic removal of a bezoar aims to remove the bezoar or break it up so it can pass through the digestive tract. The provider may use various tools to remove or break up the bezoar.

If a bezoar cannot be removed with endoscopy, surgical removal may be necessary.

Likelihood and Risks of Untreated Symptoms

Bezoars can cause serious complications, although they are rare. The complications can include:

• Perforation (a hole develops)
• Intussusception (telescoping of the intestine)
• Bowel obstruction
• Gastrointestinal bleeding
  

The likelihood of developing a bezoar is rare. A study of almost 24,000 people who had endoscopy found bezoars in 0.31% of people. Bezoars made of food material are more common in areas where persimmons grow.

Summary

Bezoars are a gastrointestinal health concern. They are made up of tightly packed food or nonfood material and are usually found inside the stomach. Many times bezoars do not cause symptoms and can go unnoticed. However, when they do cause symptoms a healthcare provider will treat it with oral solutions to dissolve the bezoar or an endoscopic procedure to break it up or remove it.