A bezoar is a solid mass that forms in the digestive system, obstructing normal function. These masses typically consist of undigested or indigestible substances, such as hair, fibers, or medications.

Certain factors, such as previous gastric surgeries, poor dietary habits, or underlying medical conditions, can cause bezoars to form. Generally, bezoars are a rare gastrointestinal (GI) finding.

While bezoars tend to be asymptomatic, some people can experience symptoms. Therefore, timely diagnosis and appropriate treatment are essential to prevent severe complications such as bowel obstruction or perforation.

This article looks at bezoars and their causes, symptoms, and treatment.

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Generally, the term “bezoar” refers to solid masses within the gastrointestinal tract. Bezoar masses can vary in composition but typically comprise undigested or indigestible substances.

There are different types of bezoars, including:

  • trichobezoars (hair)
  • phytobezoars (vegetable matter)
  • pharmacobezoars (medications)
  • lactobezoars (milk pellets)

Bezoars can occur in different locations along the GI tract, such as the stomach, small intestine, or colon. If a bezoar is in the large intestine, it is known as a fecalith. On the other hand, a bezoar in the trachea is known as a tracheobezoar.

A bezoar forms when certain substances or materials accumulate and clump together in the GI tract, creating a solid mass.

The exact process of bezoar formation can vary depending on the type of bezoar. For example, trichobezoars form when ingested hair tangles and forms a mass. In contrast, pharmacobezoars can result from ingesting medications or substances with cohesive properties or extended-release formulations that clump together.

Gastroparesis can cause bezoars to form. In people with gastroparesis, food tends to move through the stomach slowly, potentially leading to a bolus, or mass of undigested material.

Risk factors

The risk factors for developing bezoars include:

  • psychiatric disorders such as trichotillomania (hair pulling) and trichotillophagia (eating hair)
  • anatomic abnormalities of the GI tract
  • gastric surgery
  • chewing issues
  • ingestion of bulk-forming agents or extended-release medications
  • dehydration
  • vegetarian diet
  • pica, or eating nonfood items

Besides gastroparesis, other common medical conditions that associate with gastric bezoars include:

  • diabetes mellitus
  • gastrointestinal amyloidosis
  • hypothyroidism
  • scleroderma, a condition that causes abnormal collagen production

The symptoms of bezoar can vary depending on the location, size, and composition of the mass.

Common symptoms include:

  • nausea and vomiting
  • abdominal pain
  • loss of appetite
  • malnutrition
  • weight loss

Diagnosing a bezoar typically involves a combination of the following approaches:

  • Medical history and physical examination: A doctor gathers information about the individual’s symptoms, underlying medical conditions, and possible risk factors. Physical examination helps assess the abdomen for any signs of tenderness, distension, or palpable masses.
  • Imaging studies: These help visualize and confirm the presence of a bezoar. Some techniques include X-ray, ultrasonography, and computed tomography (CT) scans.
  • Endoscopy: This involves using a flexible tube with a camera (endoscope) to examine the GI tract. During an endoscopic procedure, the doctor can directly visualize the bezoar, assess its characteristics, and potentially remove it.

Bezoar treatment options include:

Endoscopic intervention

A doctor can use endoscopy alongside specialized equipment to break down or remove the bezoar. Another technique involves breaking down the bezoar so it is small enough to pass through the GI tract naturally.


Medications, such as enzyme preparations or dissolving agents, may help break down specific components of the bezoar.


Surgical intervention may help when other treatment methods are unsuccessful or if a person has complications, such as bowel obstruction or perforation.

Management of underlying risk factors

Addressing and managing underlying risk factors that associate with bezoar formation is crucial to prevent recurrence. This may involve:

  • lifestyle modifications
  • dietary changes
  • psychological support
  • treatment of any underlying medical conditions

Rarely do bezoars lead to severe complications. The complications that may occur include:

  • Bowel obstruction: As a bezoar grows, it can obstruct the typical passage of food, liquids, and digestive juices through the GI tract. This obstruction can cause the following symptoms:
    • severe abdominal pain
    • bloating and constipation
    • inability to pass stool or gas
  • Gastrointestinal perforation: A large or hardened bezoar can erode or penetrate the walls of the GI tract, leading to perforation. This potentially life threatening complication allows the contents of the GI tract to leak into the abdominal cavity.
  • Intestinal ulcers or inflammation: Bezoars can irritate and inflame the intestinal lining, leading to ulcers.
  • Intussusception: This occurs when one segment of the intestine telescopes, or slides into an adjacent segment, leading to an obstruction.

Bezoar is the formation of solid masses comprising hair, medications, or vegetable fibers in the GI tract.

The risk factors for bezoar include psychiatric disorders, previous gastric surgeries, poor dietary habits, or underlying medical conditions. While most people will not experience symptoms, sometimes a bezoar can cause abdominal pain and weight loss, among other issues.

Treatment may involve endoscopic interventions, medications to dissolve or break down the bezoar, or surgical removal. Prompt recognition and appropriate management are essential to prevent recurrence or complications such as bowel obstruction, gastrointestinal perforation, or nutritional deficiencies.