ENDOSCOPIC TREATMENT OF BEZOARS

Abstract

Based on their composition, bezoars, which are masses formed by the aggregation of foreign materials in the stomach, are classified as phytobezoars, trichobezoars, pharmacobezoars, or lactobezoars. In Japan, phytobezoars, composed of plant material, are the most common, with persimmon bezoars being particularly well-known. Persimmon tannins react with gastric acid to bind proteins, subsequently aggregating with food residues and hardening them into bezoars. While small bezoars may be naturally excreted, larger bezoars can cause various symptoms, including abdominal distension, vomiting, and gastrointestinal obstruction, which often require medical intervention. Traditionally treated surgically, bezoars can now be managed noninvasively owing to advancements in endoscopic techniques and the discovery of dissolution therapy using Coca-Cola^Ⓡ. In this study, we describe removal techniques using forceps and snares, fragmentation and cauterization with high-energy devices, and dissolution therapy with Coca-Cola^Ⓡ.