Indigestible Boluses (Bezoars)

By Atom Bergstrom

Atom’s Blog

Dr. Samuel Goodwin Gant catalogued nine varieties of intestinal calculi and concretions.

1) Gall-stones (biliary calculi)
2) Hairy concretions (bezoars)
3) Avenoliths (oat-stones)
4) Enteroliths (intestinal calculi)
5) Pancreatic calculi
6) Urinary calculi
7) Coproliths
8) Prostatic calculi
9) Miscellaneous concretions

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According to Samuel Goodwin Gant, M.D. (1902) …

“Concretions sometimes become firmly encysted and extensive dissections and considerable time are required to deliver them.

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According to CES Medicina, Vol. 23, No. 2, Jul./Dec. 2009 …

“Phytobezoars are the most common form of bezoars in humans and are primarily formed in the ileum, especially in the presence of strictures caused by Crohn’s disease, intestinal tuberculosis, previous surgery or even form inside diverticulae. They can also occur in the stomach by the concretion of poorly digested fruit and vegetable fiber predisposed by disturbed gastric motility and decreased acidity in patients after a gastrectomy or vagotomy, and by autonomic intestinal dysmotility in diabetic patients. They are mainly composed of cellulose, hemicellulose, tannins and lignin which can be found in foods such as celery, raisins, prunes, grape skins and most notably persimmons. In high concentrations these foods form a coagulum that upon exposure to and acidic environment begin the formation of a bezoar.”

According to the same source …

“Classification of Bezoars:

“Trichobezoar — Hair bezoar, in psychiatric patients who ingest hair, carpet, rope

“Phytobezoar — Composed of nondigestible food particles such as cellulose, hemicellulose, lignin

“Lactobezoar — Milk concretions especially in newborns with undigested highly concentrated milk formula

“Pharmacobezoar — Conglomeration of medications such as extended release products and laxatives

“Others — Ascaris worms, Trichophytobezoar, Diopyrobezoar (Persimmons)

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The above list is a good beginning to a longer list unknown to the general public.

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