Asymptomatic until size of bezoar impairs or obstructs gastric passage. Then common signs and symptoms include epigastric pain, abdominal mass, abdominal distention, and halitosis. If obstruction occurs, symptoms include vomiting, weight loss, anorexia, rectal pain, constipation, steatorrhea, and gastritis. Patchy nonscarring alopecia may indicate hair-pulling compulsion leading to a trichobezoar. Lab tests may show hypoproteinemia or iron-deficiency anemia.
Management methods include watchful observation, and fragmenting or dissolving the bezoar. Removal may be by endoscopy (often with Coca Cola for dissolution of phytobezoar) or surgery (laparotomy, gastrotomy). Psychiatric evaluation, behavioral therapy, nutritional support, and counseling may be helpful.
T18.2XXA – Foreign body in stomach, initial encounter
235677003 – Bezoar