Overview
A Bezoar is an accretion of foreign material that collects in the stomach and fails to move into the bowel.
Types of Bezoar
A trichobezoar is a bezoar made primarily of hair. These are
found in the stomachs of ruminant animals; in cats they are referred to
as a "hairball". In humans, a trichobezoar is most often the result of
chewing on one's hair and is most prevalent in adolescent females. The
hair occludes in the digestive tract, leading to constipation,
vomiting, weight-loss, nausea, and abdominal pain. If the
trichobezoar is large enough it is known as Rapunzel Syndrome, and
may require surgery.
A Phytobezoar is one that is composed of undigestible plant
or vegetable material, such as the seeds, pith, or skin. A prior
gastointestinal disorder is most often indicated in the case of a
Phytobezoar.
A Pharmocobezoar is composed of undigested medication in
tablet of viscous form. Often it is the result of an antacid being
prescribed which reduces the acid content of the stomach. This allows
undigested food to accrete, collecting medication in the process.
A Diospyrobezoar is one that results from eating unripened Persimmons (from the genus Diaspyros).
The flesh of persimmons contains a tannin known as Shiboul. Shiboul
polymerizes in contact with a weak acid, turning to glue within the
digestive tract. In cases of a diospyrobezoar, surgery is most often
needed.
A Harpanahalli Bezoar is one that is relegated to
Indian history. Brahmin widows of a certain region of India
would feed a pill to a stranger that dined at their table, a
pill that was supposedly composed of Chameleon Blood, among other
things. The pill would immediately begin accreting in the victim's
stomach, and if it was ever extracted, it would contain the same food
eaten at that original meal. The widows believed that by killing young
men they were assuring their own salvation.
Treatment
Bezoars can be identified by endoscopy, X-Rays of the abdomen,
or by a Computed Tomography (CT) scan. With a small occlusion the
bezoar may be dissolved following a regimen of meat tenderizer taken
with a glass of water before each meal, or may need to broken up
endoscopically. Metoclopromide may be prescribed to stimulate
peristalsis. Large bezoars often require surgery to extract them from
the abdominal wall.
Superstition
"I perceived myself seized with a pain which
forced me to rise... I had recourse to bezoar, a sovereign remedy
against these poisons, which I always carried about me."
- Jerome Lobo, A Vovage to Abyssinia
Bezoars were once believed to have the ability to neutralize any
poison that they came in contact with. The word bezoar comes from the
Persian pâdzahr, meaning "protection from poison". Stone bezoars are
still sold as magical talismans, offen marketed as "animal
pearls".
Sources:
Merck Medical Dictionary
A Voyage to Abyssinia
Radiology: Bezoars
Nathan, S. V. The Harpanahalli Bezoar. Annals of Surgery (1929) February 89(2): 314