Bezoars

Bezoars are concretions or masses of foreign material that accumulate in the gastrointestinal tract, most commonly in the stomach. These materials can range from ingested hair (trichobezoar), fruit or vegetable fibers (phytobezoar), or even undigested medications (pharmacobezoar). Bezoars can cause a variety of symptoms depending on their size, location, and the resulting obstruction or irritation to the gastrointestinal tract.

Causes and Risk Factors

Bezoars form when the digestive system fails to break down and move ingested materials through the gastrointestinal tract. Certain conditions can increase the risk of bezoar formation, including:

• Gastroparesis: A condition that reduces the stomach's ability to empty itself of food.
• Previous gastric surgery: Surgery can alter the natural motility and structure of the gastrointestinal tract.
• High-fiber diets: Diets rich in fibers can contribute to the formation of phytobezoars.
• Trichotillomania (Hair-pulling disorder): This condition, along with trichophagia (eating hair), can lead to the formation of trichobezoars.

Symptoms

Symptoms of bezoars can vary but may include:

• Nausea and vomiting
• Gastric fullness or bloating
• Abdominal pain
• Weight loss
• Malnutrition
• Gastrointestinal obstruction, in severe cases

Diagnosis

Diagnosis of bezoars typically involves a combination of patient history, physical examination, and imaging studies. Endoscopy is a key diagnostic tool that allows direct visualization of the bezoar. Imaging techniques such as X-rays, Ultrasound, and CT scans can also help in identifying and locating bezoars.

Treatment

Treatment options for bezoars depend on their size, type, and associated symptoms. They may include:

• Endoscopic removal: Small bezoars can often be broken up and removed using endoscopic techniques.
• Laparotomy or Laparoscopy: Surgical removal may be necessary for large bezoars or those that cause significant obstruction.
• Dietary changes: Reducing the intake of foods that contribute to bezoar formation.
• Medication: Certain enzymes or chemicals may be used to dissolve some types of bezoars.

Prevention

Preventive measures for bezoars focus on addressing the underlying risk factors. This may include managing conditions like gastroparesis, avoiding high-fiber diets in susceptible individuals, and seeking treatment for trichotillomania and trichophagia.

See Also

• Gastrointestinal obstruction
• Gastroparesis
• Trichotillomania
• Endoscopy