CONSERVATIVE TREATMENT OF GASTRIC BEZOARS - LITERATURE REVIEW

Abstract

Gastric bezoars are defined as hard masses of undigested material located in the stomach lumen. Classifications mainly distinguish four types: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. This article discusses conservative treatment methods that allow for the dissolution of masses or their reduction for easement of subsequent endoscopic treatment. A literature review was conducted using the PubMed database from the years 2015-2025.

The symptoms of the disease are nonspecific and include abdominal pain and early satiety. If untreated, they can cause serious complications, including gastrointestinal bleeding, intestinal obstruction and intestinal necrosis. Diagnostic methods mainly include endoscopy, considered the gold standard in the diagnosis of bezoars. Conservative methods include enzymatic substances such as cellulase, papain, and N-acetylcysteine, or chemical substances such as Coca-Cola or bicarbonate. The presented forms of conservative treatment allow for the implementation of effective treatment without invasive procedures, thereby reducing the number of complications associated with the treatment.

This article summarizes methods of conservative treatment for bezoars and serves as a tool for clinicians dealing with the therapy of this condition. As stated before, there are several forms of conservative treatment; however, their differentiation is mainly related to the etiology and origin of the lesion diagnosed in imaging studies. The manner in which the lesion develops determines the selection of the appropriate conservative treatment technique; however, an analysis of the available literature clearly shows that conservative treatment is an effective form of therapy for a selection of patients.