What are bezoars?

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Bezoars, indigestible or partially digestible formations, can cause blockages and digestive problems if not treated or removed promptly. They can form from ingesting hair, seeds, pills, or plant shells, and even chewing gum. Treatment may require surgery or medication.

The human digestive system can handle a wide variety of organic and inorganic materials, but occasionally substances such as hair, seeds, pills, or plant shells become indigestible or partially digestible formations called bezoars. These structures can lodge anywhere in the digestive system, but are most commonly found in the stomach, esophagus or upper intestine. Most of these formations are not considered life-threatening, but they can cause painful blockages and other digestive problems if not treated or removed promptly. Some ingested bezoars or foreign bodies can also cause intestinal bleeding and the inability to vomit. Some conditions require surgery or aggressive drug treatments to be removed from the body or rendered harmless.

Many people may be familiar with the feline condition known as hairballs. A cat will often ingest a significant amount of hair during grooming and this hair can accumulate in the animal’s stomach to form a semi-solid, indigestible ball. The same process can lead to the formation of a bezoar in the human body. A child may habitually chew on the ends of his hair, for example. Swallowed hair collects in the baby’s stomach and forms a frozen lump.

As more hair is ingested, more bezoars may form or the original will increase in size. A small ball of hair or bezoar trapped in a child’s stomach may not be seen as problematic, but a larger one could migrate to the stomach sphincter and become trapped in the upper intestine. Large untreated structures can cause a variety of digestive problems, including chronic constipation and blood in the stool. Surgery or medicine may be needed to remove the blockage or break it into digestible pieces.

Some people develop this condition from eating certain foods. Some vegetable seeds have outer shells that are indigestible or slow to break down in the stomach. These seeds could accumulate in the stomach and form annoying bezoars. Other foods may contain indigestible shells or husks that remain in the stomach long after the food itself has been processed.

An urban legend about the life span of ingested rubber contains a kernel of truth; chewing gum and other candies made from synthetic rubber can remain in the stomach and form harmful bezoars. This would require swallowing a significant amount of gum, however, and most individual pieces of gum swallowed will pass through the rest of the digestive tract without incident.

Some bezoars show up on traditional X-ray films, along with ingested foreign objects. A child with a large bezoar in his stomach may need behavior modification therapy to curb the urge to chew his hair, or his hair may need to be cut to prevent future accidents. For blockages caused by food, a doctor may prescribe medications that chemically soften or dissolve them.
Particularly large examples may require surgery, either through the abdomen or with instruments introduced through the esophagus. Sometimes a surgeon will physically remove the entire bezoar, while other times they will break the mass into smaller, more digestible pieces. Most often, however, the lumps dissolve over time or pass through the digestive system along with other ingested foods.




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