Bezoar
Trichobezoar; HairballA 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.
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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.
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Symptoms
Symptoms may include:
- Indigestion
- Stomach upset or distress
- Nausea and vomiting
- Diarrhea
- Pain
- Gastric ulcers
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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.
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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.
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Outlook (Prognosis)
Full recovery is expected.
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Possible Complications
Persistent vomiting can lead to dehydration.
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When to Contact a Medical Professional
Contact your provider if you suspect your child has a bezoar.
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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.