What is a bezoar?

What is a stomach bezoar?

When a material gets stuck in the digestive tract, usually in the stomach or esophagus, it is called a bezoar. “A bezoar corresponds to the impaction in the digestive tract, most often in the stomach or in the esophagus, of a substance or a foreign body which has nothing to do there or, at least, which does not belong there. “isn't supposed to stay there”, underlines Dr Guillaume Deest, gastroenterologist in Châteauroux.

The different types of bezoars

There are different types of bezoars. The most common are phytobézoards, composed of residues (fibers, skin, seeds) of undigested plants, or partially digested in the stomach. “Leeks, asparagus, persimmon, etc. are some of the particularly fibrous plants that can cause this type of problem.“, explains the specialist.

Another type of bezoar: trichobézoards. This type of bezoar affects women suffering from trichotillomania and trichophagia, who pull out their hair before ingesting it. THE lactobézoards define clumps of milk proteins stuck in the digestive tract. As to pharmacobézoardsthey characterize drug residues stuck in the digestive sphere. “This is sometimes the case with large capsules which can get stuck in the esophagus or duodenum”adds the specialist.

What causes a bezoar?

Whatever their cause, bezoars can be caused by mechanical problems or chewing difficulties. “This concerns elderly people who have problems with dental appliances and who will have a tendency to swallow food rather than chew it. illustrates the gastroenterologist. When the chewing phase, which allows food to be pre-digested, proves incomplete, compact food residues can remain stuck in the esophagus.

People who have undergone anatomical or functional changes in the stomach, involving digestive motor skills, after a surgical procedure, for example, may also be affected.

Another possible cause: treatments that will slow gastric emptying. Thus, medications for obesity or diabetes can also play a role in the formation of a bezoar.

In the majority of cases, bezoars are asymptomatic and go unnoticed. They are most often discovered incidentally, during endoscopy. Foul breath (halitosis) can indicate the presence of stagnant food in the stomach, but it is not a specific symptom. “More rarely, bezoars can cause more serious problems such as obstruction, perforation, or intestinal intussusception, that is to say a turning of the intestine on itself which then enters a digestive segment. downstream”, continues Dr Guillaume Deest. In these situations, other clinical signs are present: abdominal pain, bloating, vomiting, etc.

Diagnosis and treatment of a bezoar

To make a diagnosis, the doctor relies on x-rays and other imaging tests. An endoscopy also allows you to observe the digestive tract. If it often turns out to be benign, the presence of a bezoar should be the subject of consultation with a doctor in order to avoid a possible digestive complication, such as an obstruction or perforation for example.

In all cases, it is above all a matter of finding the cause of the digestive blockage and considering a suitable solution: psychological care for women suffering from trichophagia, adaptation of textures in the diet of the elderly, etc.

As a first intention, it involves administering medications which will stimulate digestive motility to dissolve the bezoar. “Carbonated drinks like Coca-Cola can also contribute to the dissolution of materials. notes the gastroenterologist.

Most often, it is under endoscopy, performed under general anesthesia, that the doctor will succeed in extracting the substance blocked in the stomach. “Using pliers, nets and other specific objects, we will gradually recover the compact pieces of plants. explains the doctor.

In the event of a complication, that is to say perforation or intestinal obstruction, the treatment will be surgical.