Bezoar

A bezoar is persistent concretion of indigestible material trapped in the gastrointestinal system1. They can be composed of either organic or inorganic materials. It is important not to confuse a bezoar with a psudeobezoar, which is an indugestible object intentionally introduced into the digestive system3. This may be done for treatment reasons, or otherwise may be sself-inflictedby the patient.

Bezoars of the esophagus are common in younger children. Esophageal bezoars are also reported in patients who are ventilated and nasogastrically fed due to precipitation of certain food types rich in casein. These are caused by the regurgitation of casein rich reflux which forms an Esophageal bezoar.

Pathophysiology

Bezoars can form under a wide variety of circumstances, in a wide variety of people2. They generally form when indigestible materials collect in the gastrointestinal tract. This collection will grow into a large mass as more material is ingested, leading to obstruction of the GI tract. Bezoars are common on individuals suffering from eating disorders like Pika.

Interventions

Clinical treatment varies vastly depending on the type of bezoar. Surgical intervention is often needed to remove the bezoar and restore proper gastrointestinal function.

Categories

Phytobezoar – Contains plant material
Trichobezoar – Contains hair
Lactobezoars – Contain milk proteins
Dispyrobezoar – A type of phytobezoar caused by unripe persimmons.
Pharmacobezoar – contains medications or pills.

Additional Information

Bezoars are a common component of some traditional and alternative medicines, particularly chinese traditional medicine, where an ox or cow bezoar (or gall stone) are claimed to remove “toxins” from the body4.

References

1.
Bala M, Appelbaum L, Almogy G. Unexpected cause of large bowel obstruction: colonic bezoar. Isr Med Assoc J. 2008;10(11):829-830. [PubMed]
2.
Buckley N, Dawson A, Reith D. Controlled release drugs in overdose. Clinical considerations. Drug Saf. 1995;12(1):73-84. [PubMed]
3.
Mintchev M, Deneva M, Aminkov B, Fattouche M, Yadid-Pecht O, Bray R. Pilot study of temporary controllable gastric pseudobezoars for dynamic non-invasive gastric volume reduction. Physiol Meas. 2010;31(2):131-144. [PubMed]
4.
Ingredients. In: AN KUNG NIU HUANG WAN (Bezoar Chest Functioning Pills). Peking Tung Jen Tang, Peking, China; 1980.
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  1. […] bezoar is a concretion of foreign material that can form and persist within the gastrointestinal tract. A […]

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