Approach to the management of gastric bezoars in adults

* Refer to UpToDate content on the management of GI decontamination of the poisoned patient.

¶ Symptoms of gastric bezoars include abdominal pain, nausea, vomiting, early satiety, anorexia, and weight loss.

Δ Feasibility of chemical dissolution is based on the characteristics of the gastric bezoar. Phytobezoars are generally amenable to chemical dissolution. Refer to UpToDate text for additional details.

◊ Prokinetics (eg, metoclopramide 10 mg orally before meals and at bedtime) used in conjunction with endoscopic therapy and chemical dissolution may decrease the time to dissolution of a gastric bezoar by enhancing contractions of the gastrointestinal tract and increasing their frequency.

§ Endoscopic therapy involves fragmenting the bezoar with water jet, direct suction through a large channel (6 mm) endoscope, forceps, or snares.