A bezoar is an indigestible mass composed of fibers and hair which is found in the gastrointestinal system. Consumption of hair, fibers or plastic which do not get digested, eventually form this mass.
Gastric bezoars can give rise to various debilitating symptoms. Affected individuals suffer from delayed gastric emptying, nauseas, vomiting, and early feeling of satiety, anorexia, weight loss, dysphagia and abdominal bloating. About 80% of patients with bezoar suffer from epigastric discomfort .
Physical examination is of little importance in diagnosing bezoars. However, apparently a palpable mass may be detected during physical exam. However, such finding may be an indication of other conditions and therefore more discrete examination needs to be conducted.
Plain radiographs would help in detection of mass in the abdomen. For more distinct analysis, barium swallow X-ray is indicated. In many instances, endoscopy would also be required for determining bezoars in the esophagus or stomach . In addition, CT scan of the abdomen is also indicated for diagnosing bezoars and identifying associated complications .
The prognosis of the condition is extremely favorable with full recovery. Medications or surgery can help get rid of the bezoar and individuals can also get prompt relief from the debilitating symptoms .
Consumption of substances containing hair or fizzy materials knowingly or unknowingly favors the development of bezoars. The incidence of bezoars is a common occurrence in animals. In humans, it is thought to occur in children or adults with intellectual disability or in those who are suffering from psychiatric illness . Apart from being a common occurrence in this population, bezoars in adult patients occur due to manipulation during operative procedures such as vagotomy and partial gastrectomy .
In addition, there are various other predisposing factors that favor bezoar formation. These include disease conditions such as diabetes mellitus, hypothyroidism, Miltonic dystrophy, Guillain-Barré syndrome, cystic fibrosis and intrahepatic cholestasis.
The incidence rate of bezoars in humans is low. Mortality rates associated with the condition is about 30%. The fruit persimmon has been linked to occurrence of bezoars in humans. It has been reported that, excessive consumption of persimmon caused an outbreak of intestinal bezoars. About 90% cases of intestinal bezoars occurred due to high consumption of persimmon.
Animals are known to fall easy prey to this condition. In the past era, in the Middle Ages bezoars were considered as valuable possessions and were frequently used for designing jewelry.
Bezoars are composed of undigested materials and may contain hair, fiber, medications, food or even chewing gum. These materials do not get digested and as a result also do not pass down the small intestine. Bezoars are more commonly found in the stomach, although they can develop anywhere between the esophagus and rectum.
Individuals with past history of gastric surgery or an altered function of gastric motility, wherein there is significant loss of peristaltic motility, are more prone to develop bezoars .
Individuals who have suffered from a bezoar in the past should be careful about its recurrence in future. Parents should be cautious and keep an eye on children who have habit of putting everything inside their mouth. All indigestible materials should be kept out of reach and they should also cut their children’s hair short, so that they can no longer chew their hair.
Indigestible materials may get trapped in the gastrointestinal system. As these are not digested, they do not further pass through the small intestine. Bezoars are of 4 types which have been categorized based on their composition: phytobezoars, trichobezoars, lactobezoars and pharmacobezoars. Phytobezoars constitute of vegetable matter and are the most common form; whereas trichobezoars consists of hair and fiber materials. Lactobezoars primarily consist of undigested milk matter and pharmacobezoars are also known as medication bezoars which form due to certain medications .