Diabetics - Beware of Bezoars!

March 3rd, 2011

Bezoars were once prized as magical charms with protective properties. Modern day bezoars are now being battled with weapons like meat tenderizer and Coca Cola, especially in diabetic gastroparesis.

A bezoar is a mass of hardened, undigested food or other material trapped in the digestive system, usually the stomach. Bezoars can also form in the large intestine, the trachea, and the esophagus (especially in children).

The word "bezoar" comes from the Persian for "protection from poison". Bezoars from animals were once believed to be antidotes for any type of poison, and were highly prized and sought after in Europe as a type of medical good luck charm for centuries.

People would place bezoars in their drinking glasses as an antidote to any potential poisons, and even set them into jewelry. There was a gold-framed bezoar in the Crown Jewels of Queen Elizabeth I as recently as 1962. Animal bezoars are still in demand from some practitioners of Asian medicine.

Bezoars are often found in people with diabetes mellitus and impaired gastric functioning, both of which can cause underactive digestive systems. Food that sits motionless in the digestive system mixes with mucus and solidifies into a stone-like lump.

Bezoars are classified by their content. Phytobezoars are the most common type, and are formed from undigested plant material. A diospyrobezoar is a common sub-type of phytobezoar formed specifically by the consumption of unripe persimmons.

Pharmacobezoars are masses of undigested drugs, usually found after an overdose of sustained release medications or antacids. Lactobezoars are formed from milk and other dairy products.

Trichobezoars are basically a large hairball, and are usually the result of a psychiatric condition called trichophagia which involves the compulsive pulling out and eating of hair, which humans can not digest. In 2007, Chicago surgeons removed a ten-pound hairball from the stomach of a young woman with the condition.

Doctors usually treat bezoars by attempting to dissolve them with enzymes, with many doctors directing their patients to swallow meat tenderizer. Severe cases may require surgery, laser therapy or shock wave therapy. Since 2002, there have been a number of cases, primarily in diabetes mellitus patients, where doctors successfully used Coca Cola therapy to dissolve diospyrobezoars.

One documented case involved a diabetic gastroparesis patient with three large diospyrobezoars in his stomach. He was instructed to drink two cans of Coke every six hours. Within 24 hours, the bezoars softened and began to dissolve. The doctors then injected cola directly into each bezoar, which caused them to completely dissolve by the next day. Doctors aren't sure why cola helps dissolve bezoars, but assume it's because of its acidity, possibly aided by its carbonation.

The symptoms of a bezoar are similar to those of gastroparesis (delayed gastric emptying), and include nausea, vomiting, abdominal pain, diarrhea, and a feeling of being full after eating a small amount of food. As diabetes and gastroparesis often occur together, any such symptoms should be taken seriously by a diabetic.