Bezoars--when the 'knot in the stomach' is real

Area of Science:

• Gastroenterology
• Digestive Health

Background:

• Bezoars are concretions of indigestible material (fruit fibers, vegetable matter, hair) in the gastrointestinal tract.
• They can lead to acute obstruction or chronic digestive and nutrient absorption problems.
• Risk factors include gastrointestinal surgery (especially gastric reduction for obesity), certain diseases, and medications.

Purpose of the Study:

• To summarize the current understanding of bezoar formation, risk factors, and treatment modalities.
• To highlight the role of enzymatic dissolution as a primary non-surgical treatment option.

Main Methods:

• Review of existing literature on bezoars.
• Analysis of risk factors and predisposing conditions.
• Evaluation of current treatment strategies, including surgical and non-surgical approaches.

Main Results:

• Bezoars pose a significant risk for patients with a history of GI surgery, particularly bariatric procedures.
• Enzymatic preparations are effective for bezoar dissolution in non-emergency cases.
• Surgical intervention remains necessary for acute obstructions.

Conclusions:

• Bezoar formation is a recognized complication, especially post-GI surgery.
• Non-surgical enzymatic dissolution is the preferred treatment for uncomplicated bezoars.
• Prompt diagnosis and appropriate management are crucial for patient outcomes.