A bezoar is a tightly packed mass of undigested or partially digested material that collects within the gastrointestinal tract, most often settling in the stomach. This accumulation of foreign material cannot pass through the digestive system naturally, potentially leading to a blockage. While many people seek “natural” ways to eliminate a bezoar, it is a serious medical condition that requires careful and immediate professional monitoring and diagnosis. Attempting self-treatment can delay necessary and proven medical interventions.
What Causes Bezoars to Form
Bezoars are classified based on the materials they contain, and their formation is closely linked to specific risk factors. The most common type is the phytobezoar, composed of indigestible vegetable fibers, skins, and seeds found in fruits and vegetables like persimmons, celery, or sunflower seed shells. The trichobezoar is a mass formed from swallowed hair, which often suggests an underlying psychiatric condition such as trichophagia. Pharmacobezoars are concretions of undissolved medications, particularly certain extended-release formulations.
The accumulation of these substances is often secondary to impaired digestive function. A primary risk factor is impaired gastric motility, or gastroparesis, where the stomach empties food slowly, commonly seen in people with diabetes or certain autoimmune disorders. Reduced stomach acid (hypochlorhydria) or a smaller stomach size following bariatric or ulcer surgery can also prevent proper breakdown of materials. Poor chewing habits, often due to a lack of teeth or poorly fitting dentures, contribute significantly to the formation of phytobezoars.
When Medical Intervention Is Necessary
Bezoars can be asymptomatic, but the presence of certain symptoms indicates the need for immediate medical attention to prevent severe complications. These symptoms include persistent abdominal pain, unexplained weight loss, chronic nausea and vomiting, or a sensation of fullness after consuming only a small amount of food. If left untreated, a bezoar can cause complications like gastric ulcers, gastrointestinal bleeding, or a complete intestinal obstruction.
The standard diagnostic process begins with imaging tests, such as X-rays, ultrasound, or a computed tomography (CT) scan, to visualize the mass. The definitive step is usually an upper endoscopy, where a flexible tube with a camera is inserted to directly examine the bezoar, confirm its composition, and determine the best removal strategy. Endoscopy is also a primary intervention, allowing a physician to use specialized tools like snares or forceps to fragment the mass into smaller pieces that can pass naturally or be extracted.
If the bezoar is too large or too difficult to fragment endoscopically, pharmacologic dissolution may be attempted under medical supervision. This involves administering prescribed enzymes, such as cellulase, which specifically targets the cellulose in phytobezoars to break down the mass over several days. In cases where the bezoar is particularly hard, impacted, or has caused a complication like obstruction or perforation, surgical intervention is necessary. Surgery is generally reserved as a last resort for complex cases, especially large trichobezoars, that do not respond to less invasive methods.
Exploring Dietary and Enzymatic Options
The desire for a “natural” remedy primarily applies to supportive care for bezoars, particularly the phytobezoar type, and should not replace professional medical treatment. One common medically supervised strategy for phytobezoar dissolution involves the ingestion of carbonated beverages like Coca-Cola. This is thought to work due to the combination of carbonation and the low pH of the soda, and is often used with prescription cellulase enzyme therapy.
Dietary modifications are most effective as a preventive measure or as an adjunct to medical removal. After a phytobezoar is removed, patients are advised to follow a low-fiber, low-residue diet and ensure proper mastication to prevent recurrence. This involves avoiding high-fiber foods that are difficult to digest, such as persimmons or certain raw vegetables. Increasing fluid intake and eating small, frequent meals can also promote better gastric emptying.
While over-the-counter enzymes like papain or bromelain are sometimes suggested, their efficacy against an established, solid bezoar is limited and they are not a substitute for prescribed medical treatment. These “natural” enzymes lack the targeted strength and delivery methods used in controlled medical settings. Focusing on supportive dietary changes and preventing recurrence is the safest approach.