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Bezoar

Definition

A bezoar is a ball of swallowed foreign material most often composed of hair or fiber. It collects in the stomach and fails to pass through the intestines.

Causes

Chewing on or eating hair or fuzzy materials (or indigestible materials such as plastic bags) can lead to the formation of a bezoar. The rate is very low. The risk is greater among people with intellectual disability or emotionally disturbed children. Generally, bezoars are mostly seen in females aged 10 to 19 years.

Symptoms

Symptoms may include:

• Indigestion

• Stomach upset or distress

• Nausea and vomiting

• Diarrhea

• Pain

• Gastric ulcers

Exams and Tests

The child may have a lump in the abdomen that can be felt by the health care provider. A barium swallow x-ray will show the mass in the stomach. Sometimes, a scope is used (endoscopy) to directly view the bezoar in the stomach.

Treatment

The bezoar may need to be surgically removed, especially if it is large. In some cases, small bezoars may be removed through a scope placed through the mouth into the stomach. This is similar to an EGD (esophagogastroduodenoscopy) procedure.

Outlook (Prognosis)

Full recovery is expected.

Possible Complications

Persistent vomiting can lead to dehydration.

When to Contact a Medical Professional

Contact your provider if you suspect your child has a bezoar.

Prevention

If your child has had a hair bezoar in the past, trim the child's hair short so they cannot put the ends in the mouth. Keep indigestible materials away from a child who has a tendency to put items in the mouth.

Be sure to remove the child's access to fuzzy or fiber-filled materials.

References

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Foreign bodies and bezoars. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 360.

Pfau PR, Benson M. Foreign bodies, bezoars, and caustic ingestions. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 28.

Review Date: 8/5/2023

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.