Every year, a dozen or so people go to hospitals to “store” undigested remains of food and other accidentally (or intentionally) swallowed hair or fibers in their stomachs. Experts talk about these tumor-like creations, bezoars.
Under this nice, or even exotic sounding name, there are undigested fragments of plant fibers, medicines, and sometimes also hair swallowed accidentally or intentionally by people with mental disorders.
The reason for the formation of hard, tightly sticky formations in the stomach is usually difficulties in moving them to the distal part of the gastrointestinal tract. Typically, this is when the pylorus is narrowed and the stomach walls do not constrict enough to push food into the rest of the digestive tract. Another cause of bezoar formation is gastric surgery, which has impaired normal stomach function.
Another cause of bezoars can be dental problems, such as missing teeth, diseases of the jaw that prevent good grinding of food, and poorly fitting dentures.
It also happens to people who have low levels of acid in the stomach, making it difficult to digest properly.
The tendency to form bezoars also occurs in some people with diabetes, hypothyroidism or suffering from connective tissue diseases.
If the stomach is less fit, the body produces more mucus. This, in turn, does not speed up digestion, but only clumps undigested debris into bumps. They can be of different sizes. They can be the size of a pea, walnut, and sometimes even the size of a tangerine.
No symptoms
Small bezoars often do not cause any discomfort. When they get larger, the person may lose their appetite, feel full even after a small meal, feel nauseous or experience pain in the upper abdomen (epigastric region). Any such ailment should be discussed with the primary care physician, as similar symptoms may occur in gastrointestinal malignancies.
If undigested debris clumps into a ball, it is difficult to detect without specialized testing. Only very large bezoars can be felt by the doctor by examining the patient’s abdomen with his fingers. Usually, however, these changes are detected accidentally, e.g. during an X-ray of the stomach.
However, the best method of diagnosing such changes is endoscopic examination. First of all, it allows to distinguish a bezoar from another lesion, e.g. cancerous. In addition, if the undigested debris is quite soft, it can be divided into smaller pieces and removed from the stomach using an endoscope.
Classification of bezoars
In humans, bezoars can occur in the stomach, esophagus and rectum. Depending on what ingredients they are made of, there are three basic groups of these creations:
headquarters – they usually contain plant fibers derived from undigested leftover fruit, cereals and vegetables.
trichobezoary – they are made of swallowed hair. They are found in men with a beard or mustache and in women who are their partners. Such bezoars are also detected in people who swallow their hair as a result of mental disorders.
farmakobezoary – they contain drug residues that have not been digested. Their formation may occur after frequent use of preparations containing aluminum, calcium, magnesium carbonate and nifedipine (a component of heart medications).
However, clinical practice shows that the bezoars can also contain fragments of cement, plastics (including furniture sponge), paper, polystyrene, cotton wool and lignin.
Sometimes you have to operate
Very large and hard structures made of the remains of swallowed and undigested things must be removed surgically. Failure to do so exposes the patient to abdominal pain, daily discomfort, but also to more serious complications, such as gastrointestinal obstruction, intestinal perforation or haemorrhage. Although cases of gastrointestinal obstruction or its damage are rare, they must be taken into account when the doctor makes a decision about further therapeutic treatment.
The operation is not a complicated procedure in this case. After its completion, the patient quickly returns to full fitness.
After treatment
People who are prone to bezoar formation after surgery must avoid all foods that may cause them to re-emerge. You should also avoid swallowing large, carelessly chewed pieces of meat, as well as vegetables and fruit, which contain a lot of hard-to-digest fibers, e.g. raw pineapple, kohlrabi. Immediately after surgery, a semi-liquid diet is most appropriate. You can eat anything, but you should pay attention to the way you prepare your meals. For example – if you want to eat a pineapple slice for dessert, it is better to blend it. The same should be done with kohlrabi, which is sometimes added to the soup. It is better to dice other vegetables and fruits than to swallow large pieces. It is also important to drink at least 2 liters of fluid every day so that the food in the stomach is thinned. Thanks to this, it will be digested faster and it will be easier to move to further parts of the digestive tract.
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