Bezoar. Stomach stone. Bezoar from "Harry Potter" exists in reality. But it's not that that's amazing, it's the price.

Stones of organic origin are sometimes formed in the stomach. In medicine, they are called bezoars. Such formations are most often observed in children and women who have a habit of sucking their hair, tend to consume certain foods in large volumes. Symptoms for this pathology may vary, depending on the size of the stones in the stomach.

What is the essence of the disease?

Bezoars come in a variety of shapes, textures, and sizes. As a rule, agglomerates consist of solid particles of food, hair and other unsplit elements. As they accumulate, stone-like formations are formed, which can increase in size. The growth rate depends on the composition of the bezoar, as well as the characteristics of the human body. AT medical practice single severe cases when it grew to such a size that it filled the entire stomach.

The consistency of the agglomerates can be loose, soft or hard. By number - single or multiple. They are usually brown or green in color bad smell.

Types and causes

There are several types of stones in the stomach:

• phytobezoars- are most common, the cause of the appearance is the accumulation of coarse plant fiber (figs, persimmons, grapes and others), occur as a result of insufficient chewing of food, with gastritis, disruption digestive organ;
• trichobezoars- formed from hair, most often found in people who have a habit of sucking their own strands and those whose professional activity associated with hair
• lactobezoars- mostly found in infants, whose nutrition is based on lactose and casein;
• sebobezoars- occurs as a result of fat accumulation plant origin consumed with food in large quantities;
• haemobezoars- usually seen in people with systemic lupus erythematosus or portal hypertension, in which blood is swallowed;
• pixobezoars- formed when eating resin;
• shellacobesoars- appear due to falling into digestive system nitro varnish, varnish, alcohol varnish and other harmful substances.

Patients after gastric surgery are most prone to the formation of such stones. Patients with diabetes are also at risk.

Characteristic symptoms

Stones may be in the stomach long time without showing any symptoms. Thus, a person throughout years may not be aware of the disease.

When the formation reaches a certain size, the following clinical signs may appear:

• dull pain that gets worse after eating;
• instant satiety, despite eating a small amount of food;
• heaviness in the abdomen;
• nausea;
• belching with an unpleasant odor;
• vomiting after eating.

Symptoms depend on the size, nature, time of the formation in the digestive organ. AT childhood pathology can manifest itself as severe pain and swelling.

Bezoars, larger in size, manifest themselves more intensely.

In such cases, the following clinical signs occur:

• weight loss;
• an increase in viral and infectious diseases;
• fast fatiguability;
• fragility of nails, deterioration of teeth;
• unhealthy complexion;
• weakness.

Acute pain and debilitating vomiting accompany the patient in case of pinching of the stone in the exit zone of the organ.

Diagnostics

On palpation, it is possible to detect only large formations that are distinguished by good mobility.

As a rule, the following diagnostic studies are carried out:

• radiography- during the study, defects are detected that have a certain size and clear boundaries, they can be mobile or fixed in the wall of the stomach (in the latter case, the disease can be confused with cancer);
• gastroscopy- endoscopic examination, allows you to visually assess the size, shape, structure of the bezoar, determine the state of the mucous membrane;
• ultrasound- is carried out only in cases where there are contraindications for the two previous types of diagnostics.

By general analysis blood can detect signs of anemia, which also indicates the development of the disease.

Treatment Methods

In the absence of complications, conservative treatment, which is assigned depending on the type of education, as well as other characteristics.

If the consistency of the agglomerate is soft, you can get rid of it by drinking warm alkaline mineral water. The course of treatment is up to two weeks. In this case, you will have to follow a diet with a restriction on the amount of vegetables and fruits consumed raw. Soft agglomerates can sometimes be destroyed by conventional massage.

Also used for treatment mechanical way, the essence of which is to remove the stone with an endoscope or crushing by exposure to special solutions under pressure. To accelerate the removal of agglomerate particles, prokinetics are used. They are able to increase the motility of the digestive organ. Also, drugs are prescribed that tend to envelop the mucous membrane, protecting it from negative effects.

In rare cases, when the bezoars are hard and large, the doctor decides on a surgical intervention, during which the agglomerates are removed.

Prevention

Preventive measures are as follows:

• proper nutrition;
• active lifestyle;
• getting rid of the habit of sucking hair and biting nails;
• timely examination by a gastroenterologist;
• slow and thorough chewing food;
• restriction of roughage, berries, fruits and vegetables with a hard skin.

Complications

When agglomerates grow to large sizes they can lead to complications. One of them is the infringement of the bezoar, which is manifested by sharp pain and prolonged vomiting. Sometimes there is an obstruction of the stomach when its outlet is blocked.

Relevance. This pathology relatively rare in childhood, and in this regard, practical pediatricians are not familiar enough with the clinic and diagnosis of this disease. Meanwhile, bezoars often cause severe and life-threatening complications. They cause the formation of gastric ulcers, penetration, perforation, gastrointestinal bleeding, necrosis of the stomach wall, acute obstructive thin or thick intestinal obstruction, anemia, cachexia, allergic dermatitis and other complications. If in adult patients the etiopathogenesis of bezoars is known to some extent, then in children the causes of the formation of bezoars of the gastrointestinal tract (GIT) have not yet been studied enough.

bezoars- this is special kind foreign bodies formed in digestive tract, mainly in the cavity of the stomach, from various ingested substances. The term "bezoar" is associated with the name of the breed of mountain goats, in the stomach of which they are found most often. In the Middle Ages, gastric bezoars were attributed magical property protection from poisons, so another interpretation of the term, borrowed from Arabic, suggests "antidote".

Type of bezoar determined by its composition (cf. classification). Most often in children there are phyto- and trichobezoars. Other types of bezoars (shellacobesoars, sebobezoars, etc.) are practically not found in children. Some authors report the formation of lacto- and myxobezoars in combination with malformations of the duodenum, as a result of a violation of evacuation from the stomach.

The reasons. The main reason for the formation of bezoars of the gastrointestinal tract in children is the uncontrolled intake of non-arogenic herbal products(persimmon, grapes with pear stones, figs, nuts, peaches, oranges, etc.) and non-food substances (resin, plasticine, etc.). Among phytobezoars, the most frequently reported in the literature are diospyrosbezoars formed from persimmon, which contains a large number of resinous substances (shibuols) that undergo coagulation under the influence of gastric juice and contribute to the adhesion of persimmon parts into a dense mass. According to the recommendations of a number of authors, persimmon should be completely excluded from the diet of children, and a number of other non-arogenic foods, especially citrus fruits, should be consumed in early childhood under the strict supervision of adults and in limited quantity. After any surgical operations within 3 - 6 months, it is preferable to take fruits and vegetables in the form of juices, since the formation of bezoars most often occurs in postoperative period out of postoperative intestinal dysmotility, which is facilitated by a violation of the diet with uncontrolled reception a large number of fruits and vegetables (bananas, oranges, peaches, etc.).

The main reason for the formation of trichobezoars is the ingestion of hair by children with trichotillomania (usually against the background of psychogenic depression). As a result, a "hair tumor" is formed in the stomach, consisting of a ball of intertwined and glued hair, saturated with food masses and mucus. After removing the "hair tumor" to prevent the recurrence of trichobezoar, it is necessary dispensary observation psychoneurologist and pediatric gastroenterologist with regular examination GIT.

Available studies indicate a large role of anomalies of the gastrointestinal tract, especially the gastroduodenal zone, in the formation of bezoars in children (for example, congenital duodenal membrane, annular pancreas, megaduodenum, hyperfixation of the duodenum at the level of the duodenojejunal junction, diverticula, etc.). Dysmotility of the gastrointestinal tract contributes to the retention and compaction of food masses, the concentration of indigestible substances in the abnormal area and, ultimately, the rapid formation of a bezoar. For the prevention of such stones, it is necessary early diagnosis anomalies of the gastrointestinal tract.

Symptoms. Before proceeding to clinical picture bezoars, it is necessary to highlight the duration of the formation of bezoars and their possible localization. The duration of the formation of a bezoar in most cases remains unknown, it is determined by its composition, the habits of the patient, the characteristics of gastroduodenal secretion and motility. Phytobezoars from immature persimmons (diospirobezoars) can form most quickly (within a few days). There are cases of rapid (only within a few hours) development of phytobezoars when oranges, bananas, peaches are consumed in conditions of gastrostasis after abdominal operations. The sizes of bezoars vary: from a few millimeters in diameter to giant formations that fill the internal volume of the stomach (typical for trichobezoars). Their consistency varies from soft to stony. Bezoars are localized more often in the stomach, less often in the esophagus and duodenum, Meckel's diverticulum. Cases of migration of bezoars into the small intestine with a clinic of acute or recurrent intestinal obstruction are described.

The clinical picture of bezoars is varied. Usually, at first, bezoars are oligosymptomatic. As the bezoar increases, pain and a feeling of heaviness in the epigastrium, nausea, vomiting, loss of appetite appear, leading to weight loss. Palpation in most patients can determine the tumor-like formation in the epigastrium. Most frequent complication bezoars - ulceration of the gastric mucosa (gastritis), with the development of bleeding. Large and dense bezoars can cause perforation of the stomach wall, with the development of peritonitis. Rarely, bezoars can lead to allergic manifestations(allergic dermatitis, angioedema, etc.).

Diagnostics. In the diagnosis of bezoars great importance have a history. You should ask the child and his parents whether he has consumed non-arogenic foods, whether he has a tendency to chew gum, swallow hair or wool. Girls should be examined hairy part heads. Special Methods diagnostics allow to establish the true pathology. Ultrasound procedure(ultrasound) locates a hyperechoic formation in the stomach, giving behind acoustic shadow indifferent to the wall of the stomach. At endoscopy(fibrogastroduodenoscopy - FGDS) phytobezoars of the stomach look like a yellow-greenish formation, with a rough surface, a dense consistency with "instrumental palpation". Trichobezoars look like a dirty gray tumor covered with hair that fills the entire stomach cavity. At x-ray examination of the gastrointestinal tract in the cavity of the stomach is determined by a non-homogeneous filling defect that does not communicate with the wall of the stomach.

Treatment. The treatment of dense, large bezoars is surgical. Less dense and small bezoars (phyto-, pixo-, sebobezoars) can be removed endoscopically, sometimes in several stages. With existing lesions of the gastrointestinal tract, a one-stage reconstructive operation with the removal of the bezoar is indicated, aimed at correcting birth defect development of the gastrointestinal tract. Theoretically, conservative treatment of bezoars is possible (in the absence of absolute indications for surgical treatment) with the use of proteolytic enzymes (papain), ingestion of 5-10% sodium bicarbonate, the appointment of antispasmodics and massage of the stomach area, however, when studying the descriptions of cases of managing patients with bezoars, the effect of such therapy does not occur (not described).

Prevention. Yu.Yu. Sokolov and M.I. Davidov (Bezoars of the gastrointestinal tract in children / Pediatrics, 2010., No. 2. - P. 60-65) as preventive measures in a relationship possible education bezoars offer: early detection and correction of anomalies in the structure of the gastrointestinal tract, contributing to the slowing down of the passage of food masses; control over the behavior of children (trichotillomania, attempts to use resins, plasticine, correct use chewing gum, etc.); reasonable consumption of non-arogenic products (persimmon, grapes with stones, etc.); The authors suggest (as mentioned above) within 3 - 6 months after operations on the digestive organs to abandon the use of whole fruits, limiting the use of only fruit and vegetable juices. As for persimmon, they advise not to use it in large quantities, especially on an empty stomach, when all the acidic gastric juice produced contributes to a sharp increase in the formation of insoluble shibuols (resinous substances). The latter recommendations are more speculative than evidence.

Feeling of heaviness in the stomach up to severe pain, belching with an unpleasant odor, vomiting, weakness, etc. Such complaints from the patient should make the doctor think. Perhaps the point here is a rather rare, but still occurring problem: the formation of a bezoar in the stomach.

First question: what is a bezoar?

Bezoar is a foreign body formed in a certain period of time mainly in the stomach. Most often, bezoars are found in ruminants, but many cases of their formation in the human body are known. Trouble in the form of a bezoar occurs due to the ingestion of substances into the stomach that are not digested in it, but accumulate and thus form a foreign body. In addition, bezoars can form due to the multiplication of fungi in the stomach. genus Candida. Bezoars have a rather interesting classification.

Classification of bezoars

Phytobezoar

Phytobezoars are the most common. A help to its formation in the stomach is a decrease secretory function the stomach, as well as a violation of the removal of contents from it, poor-quality chewing of food, etc. These bezoars are formed from plant fibers of wild persimmon, grapes, wild plums, figs, bird cherry, etc. The rate of their formation can range from 1 day to 25 years. Rapid formation comes from unripe persimmon, which contains many astringents and resinous substances. Phytobezoars can have a soft and friable texture, and can reach a density similar to natural stones. These bezoars can be either single or multiple. The color can be dark brown or green, the smell is fetid. The dimensions of this type of bezoar vary from a few millimeters to tens of centimeters. As a rule, they form in patients who have undergone surgery to remove part of the stomach. (resection) or an operation related to crossing the main trunk (or branch) vagus nerve passing to the stomach (vagotomy). This happens due to the rapid and unhindered movement of undigested products into the small intestine. But it is not possible to say for sure about the frequency of occurrence of bezoars in the stomach, because. far from all patients who have previously undergone these operations are examined using endoscopic and radiological methods research.

Trichobezoar

Trichobezoars are formed when hair enters the stomach. Most often, this type of bezoar occurs in people with a disturbed psyche, suffering from an irresistible addiction to biting hair, as well as in those whose work is related to hair. Often trichobezoars are formed in children suffering from schizophrenia. Their weight can reach 3.5 kg or more.

shellacobesoar

Shellacobesoars are formed as a result of the abuse of alcohol lacquer, nitro lacquer, and varnish by persons suffering from alcohol dependence. The thing is that shellac is a natural resin used in the production of varnishes. Polish is an alcoholic solution of shellac used in finishing work. So, with the regular use of all these liquids, shellac stones are formed in the stomach, which are found mainly in the stomach and never enter the duodenum. This type of bezoar has a brownish-white color, smooth or slightly rough surface. On the section, the shellacobesoar has a layered structure and black brown. It is also known that such a bezoar can burn, be cut with a knife, and its weight can reach 500 g or more.

Sebobezoar

Sebobezoars arise from the compaction of animal fats. Their formation is due to the fact that the melting point of fats (beef, lamb and goat fat) is higher than the temperature inside the stomach. As a result, crystallization of triglycerides occurs with the formation of fatty stones.

pixobezoar

Pixobezoars are found in persons suffering from the habit of chewing pitch, resin.

Lacto- and hemolactobezoar

Lactobesoars are formed in premature babies who are on a high-calorie artificial diet, which contains lactose and casein. Their formation occurs during the first 2 weeks of a child's life. Hemolactobesoars disintegrate on their own after gastric lavage, diet correction, use of breast milk.

Symptoms of a bezoar in the stomach

The patient complains of stomach pain, nausea, general weakness, belching with an unpleasant odor, vomiting, decreased appetite, weight loss. Sometimes there may be a movement in the stomach, reminiscent of a rolling ball. Children with a bezoar sometimes suffer from edema and hypoproteinemia due to metabolic disorders, insufficient absorption of vitamin B12 and folic acid, as well as the rapid growth of bacteria in small intestine(upper sections).

However, it should be said that symptoms in the presence of a bezoar in the stomach may be completely absent. In addition, they are not characteristic. Also, it should be noted that the "clinic" largely depends on the type, size, location and prescription of the formation of the bezoar, as well as on the complications caused by its presence.

Bezoar diagnostics

Due to the fact that the symptoms in the presence of a bezoar are not characteristic, in some patients the exacerbation of this problem is taken as food poisoning. In this case, the doctor prescribes an abundant use of water, mainly mineral water and gastric lavage, one way or another giving relief as a result of the removal of bezoar masses from the stomach. The aggravation itself can occur as these bezoar masses accumulate and subside after they enter the duodenum or are excreted through vomiting.

With a sufficient size, a bezoar of a dense consistency can be felt in the epigastric region, but there is a possibility that a bezoar in a stationary state may be mistaken for a tumor by a doctor. For this reason, in the diagnosis of a bezoar, X-ray, echographic and endoscopic methods research. According to the results laboratory research blood anemia can be detected.

In any case, to establish correct diagnosis the doctor should conduct a thorough analysis of the anamnestic data obtained from the patient, namely: previous stomach operations, the use of food of plant or animal origin and the presence bad habits that can provoke the formation of bezoars, as well as the condition of the teeth, the nature of chewing and swallowing food.

Possible Complications

In the event that the bezoar is a large stone moving towards the small intestine, it can cause recurrent intestinal obstruction up to its complete blockage. With this complication, surgical treatment is indicated.

Another complication caused by the resulting bezoar may be perforation of the stomach, as well as ulceration of its mucous membranes and bleeding. The same thing can happen with the duodenum.

Treatment for a bezoar in the stomach

In the absence of complications, treatment begins with conservative methods. It should be said that in each case it is not the same. For example, with phytobezoars that have a soft texture, you can use warm water for 1-2 weeks. mineral water("Borjomi") on an empty stomach, limit the consumption of vegetables and fruits for a while, take laxatives, spend light massage stomach, etc. Activities of this kind contribute to the destruction and removal of such a bezoar.

If the bezoar is small, it can sometimes come out on its own (like any foreign body). By the way, in children, compared with adults, promotion foreign bodies happens faster. One way or another, to speed up this process, you can use the mechanical removal of the bezoar using an endoscope or use the method of exposure to jets of solutions under pressure in order to divide the bezoar into smaller parts. Subsequently, to get rid of individual small fragments, prokinetics are used (drugs that accelerate the process of moving food through the intestines) and enveloping drugs.

As for dense and (or) voluminous bezoars (we are talking here mainly about tricho-, shellac- and pixo-bezoars), the stomach is opened (gastrotomy), and the problem is solved by removal. Also surgical intervention necessary in the absence of the effectiveness of conservative methods of treatment, regardless of the type of bezoar.

A stone of organic origin, formed in the body of some ruminants, most often in bezoar goats, consists of magnesia, oxalate and phosphate lime. The habitat of bezoar goats is the middle and high mountains of the Central Asian region. The flora here is specific - derzhidrevo, wild rose, sumac, prickly almond, wild pistachio, that is, very dense and tenacious shrubs.

Naturally, animals while moving along the slopes are forced to literally tear through the thorns. A lot of hair remains on the bushes - not only bezoar goats, but also other animals grazing in this zone. Goats swallow bundles of hair along with food. On balls swallowed by animals accumulate mineral salts, the main composition of which is calcium hydrogen phosphate.

These stones are found in the stomachs of seals, walruses and some cetaceans. In the auditory organs of fish, "auditory stones" or osteoliths, consisting of calcium carbonate crystals, are also found. The word bezoar probably comes from the Chaldean "bel" - lord and "zaar" - poison. The stone is bluish-gray or earthy in color with a blackish and reddish tint, not very hard, greasy to the touch, and has a bitter taste when crushed.

The stone has the ability to intensively absorb arsenic compounds and therefore was considered a strong antidote and was highly valued by the princes. If a bezoar stone is briefly immersed in wine containing arsenic, it will extract it from the liquid, and in return release harmless phosphate due to healing properties this nondescript gray-blue stone has been considered precious for many centuries.

AT medieval Europe The bezoar was a rare, expensive and very desirable acquisition not only for healers, pharmacists and alchemists. Secular dignitaries, princes of the church, nobles and cardinals, kings and popes sought to get it. The ongoing struggle for power forced them to live in constant expectation of assassination. And the most common method of settling accounts was poisoning.

belief healing properties the bezoara was deep and unshakable. Lawrence Catelan wrote a whole book about him, in which he enthusiastically said:

“Providence has not given mankind a more magnificent, stronger and effective remedy against poisons. The virus of disease tends to the stone, as the heliotrope turns to the sun, as the palm tree to the palm tree, as the remora ** reaches for the ship, and the orbis *** - to the wind.

The bezoar was usually worn around the neck, but it was possible to soak it in wine for a couple of hours until the wine absorbed miraculous power stone.

At Patriarch Nikon, the hilt of his staff was crowned with a bezoar stone (the so-called bezuy-stone), which he dipped into the bowl before drinking any drink. And the bride of the king used vodka infused on the bezuy stone.

The bezoar stone was constantly worn by the Queen of England, Elizabeth I. The Persian Shah sent many of these stones to Napoleon. Either the emperor was in a bad mood, or he was guided by a desire to humiliate the Persian envoy, but the great reformer ordered stones to be thrown into the fireplace. Thirty years later, the expediency of such an act already seemed doubtful. On May 5, 1821, on the island of Saint Helena, after a serious and painful illness, the ex-emperor of France, Napoleon Bonaparte, died as a result of poisoning.

Alexandre Dumas, the father, known not only as a popular and prolific writer, but also as an experimental culinary specialist, was also interested in bezoar, and even tried to create a safety sauce based on the stone.

The most valuable was considered a bezoar from East India. Travelers said that the local peasants discovered the bezoar in the following way: both hands were placed on the belly of a goat, from which they hoped to find a stone. After that, with strong pressure from both sides, the stone was squeezed out into the middle of the stomach.

The price of a bezoar, like that of a diamond, skyrocketed in proportion to its weight. Small stones per ounce (about 30 grams) accounted for 5-6 pieces. And they cost from 5 to 18 francs. A bezoar that weighed a full ounce was already worth 100 francs. For a stone weighing 4 ounces, they willingly gave 2,000 francs. When making a purchase, one had to be very careful, because the seductive price gave rise to falsifications. The dough of a certain quality was mixed with wood resin, after which small bezoars were brought to a large size with the help of this mixture. It was possible to distinguish deception in this way: the stone was weighed and then lowered into warm water. If his color did not change and he did not lose weight, everything was without deception.

Even more valuable than the bezoar, Dr. Valentini thought, was a stone found in a breed of pig from Malacca. It came into circulation under the name Piedra del Porco (pork stone), or Lapis Malacensis (Malacca stone). And our time among the bezoars there is one: a small pig is depicted on its frame. The Dutch East India Company laid its hands on a valuable export item and sold the stones for 135-175 Dutch florins apiece. The dealer asked for them already 400-600 florins. It was possible to take a stone and rent, but for every 24 hours, one gold had to be given as rent. After all, the bezoar cured of gout, colic, obesity and even jaundice.

Unfortunately, the bezoar has not yet been included in any mineralogical anthology of the world, and in vain. Even the great scholar al-Biruni, the author of the Collection of Information for the Knowledge of Jewels, exclaims: “By my life, this is the noblest of all precious stones which are stored in treasuries, for he is useful for life, and not they!

This healing stone The ancient Armenian doctor A. Amasiatsi also attached great importance, arguing that the stone that turns green when rubbed is more valuable. He believed that the bezoar saves its owner from poisons, helps with all types of animal bites, eliminating their harmful effect:“If you rub it with fennel juice and lubricate the place of the snake bite, it will help and immediately soothe the pain.” “If you give a stone weighing 12 barley grains to eat, it will help with heart weakness. And he gives strength to a person. And its dose at the reception is 1 dank (0.091 g). And the one who eats it every day half a dank is saved from all evil and poisons. The bezoar is also useful in the hot nature of the body, for it acts by virtue of its inherent properties, and not by nature. And know that the nature of this remedy is very hot."

In the old Russian medical books, a “beluga” stone is described, which was found on the sides of the holes through which the fish spews caviar. It was used for difficult childbirth, childhood illnesses, diseases of the bladder and ureters. Sometimes similar stones were found in bladder dead boar. "Boar" stone was valued even more than "beluga".

Perhaps the most valuable type of bezoar is the "pigeon" stone, which is formed in the stomach of a pigeon. According to A. Amasiatsi, a drug from a stone helps with uterine cancer. "He is one of the best medicines with cancer. It's been tested."

Among magicians, the bezoar is considered one of the effective means attracting love. To do this, it must be dried and ground into a fine powder. Then find a red apple, cut out a piece, the size of a bean, near the stem, take out the seeds, fill the void with the resulting powder and insert the cut piece in place. After that, wrap it with a peeled peel of apples the width of a finger. The sacrament is best performed on April 15 at 6 o'clock in the morning. In addition, blood taken from ring finger left hand, it is necessary to write the name of the beloved person and the word "Abuenop", and the beloved should not know about this: you should not show her a cut finger. Then you need to let your beloved eat a quarter of the apple. But you can leave the apple warm to dry, and then turn it into a powder and put it in your loved one's dress.

Few people know that stones organic nature can form in the stomach. There is such medical concept- stomach bezoar. Pathology is more common in women and children prone to predominance in the diet certain products food, having the habit of sucking their own hair. Symptoms appear as the bezoar grows in the form acute attacks pain. Severe complication blockage and complete obstruction in the intestine is considered. Reference methods for diagnosing the problem are x-rays and endoscopy.

The essence of pathology

A bezoar is a stone-like organic body with different form, consistency and size, which is formed as a result of improper nutrition and an unhealthy lifestyle.

A bezoar is formed from a collection of hair, bits of bone, large hardened pieces of food, and other undigested elements. Gradually accumulating in the stomach, they are grouped into a sphere, which gradually increases in volume. If you do not intervene in time and start treatment, the overgrown stone will provoke a complete dysfunction of the digestive system.

The growth rate of the gastric bezoar depends on the substances from which it is formed, the type and characteristics of physiology. individual person. A sphere can form in a few days or grow over decades. The consistency of formations is also different. Bezoars are soft, loose or hard, stone-like. There are single or multiple formations that are colored brown or green color with a strong, unpleasant odor. The size of gastric neoplasms is different - from small to impressive (weighing a kilogram or more). fixed rare cases when the bezoar filled the entire lumen of the stomach, representing a cast of the organ.

Main types

By physical characteristics Bezoars of the stomach are distinguished by the following varieties:

• trichobezoars;
• pharmacobezoars;
• phytobezoars;
• other species: shellacobesoars, pixobesoars, pseudobezoars, polybezoars, etc.

A feature of education is the main component - hair, which enters the stomach in large quantities. This problem is more likely to occur in people with mental disorders or those suffering from addiction in the form of biting and sucking hair. Trichobezoar appears at hair stylists. There are frequent cases of diagnosing a problem in children with schizophrenia.

After hitting hairy particles in large quantities and processing them gastric juice, the lump becomes sticky. Due to this, food masses quickly stick to it. Gradually, a dense calculus is formed. If the problem is not detected in time, the bezoar, without being digested, will begin to move into the intestine, which can provoke blockage of the evacuation section of the stomach and pain.

The mass of such formations can reach 4 kg and above.

Phytobezoars

They are among the most frequent agglomerates in the stomach - 70% of all recorded cases. The reason for their formation is considered to be a decrease in the secretory activity of the stomach. The process of removing the contents from the organ further into the intestine is disrupted, which causes pain. The main provocateur is poor-quality chewing of food during meals. The composition of phytobezoars is formed from particles of wild persimmon, grapes, plums, figs, bird cherry, which are enriched with coarse plant fibers and have a dense skin. An immature persimmon containing a large amount of binders and resins is capable of starting the rapid process of creating a bezoar. Size - from 1 mm to tens of centimeters.

Pharmacobezoars

Gastric agglomerates, which contain particles of insoluble drugs, in particular, sucralfate and gel-like aluminum hydroxide. They differ in density. In a compressed clot, particles can also be detected. undigested food. At risk are people with various pathologies that require constant drug treatment.

Other types

Other types of bezoars are even rarer. These include:

• pixobesoars - agglomerated from particles of resin or pitch;
• sebobezoars - formed against the background of the habit of eating fatty foods animal origin;
• shellacobesoars - result prolonged intoxication polishes and nitro-lacquer (the problem is typical for construction and repair workers);
• lactobesoars - found in children on artificial feeding low-quality mixture with lactose and casein.

Causes of stones in the stomach

The rarity of the development of pathology in the stomach does not exclude the risk of its occurrence. The fact is that there are many provoking factors that together can lead to the problem of stone formation in the stomach. The main reason is a violation of the motor function, which is responsible for the evacuation food bolus from the stomach to the intestines. Typical disease provocateurs - complications diabetes(diabetic gastroparesis, partial paralysis of the stomach).

The following provoking factors are of no less importance:

• weakening of the secretion of the gastric glands, a decrease in acidity;
• colonization of the intestines and stomach pathogenic microflora(yeast-like fungi);
• increase in mucus viscosity.

People at risk are:

• badly chewing food, abusing rough and fatty foods;
• undergoing stomach surgery (partial resection, vagotomy) and not undergoing follow-up examinations.

Typical signs

The main risk is that the bezoar is able to stay in the stomach without showing itself for many years. But under certain circumstances, there are some symptoms that allow you to suspect something was wrong. The clinic of the disease depends on foreign bodies, weight, nature, etiology, localization, residence time in the stomach. In children, it is manifested by edema, pain or hypoproteinemia. Symptoms develop against the background of metabolic disorders due to the growth and filling of the lumen of the stomach with a bezoar.

The characteristic signs of the presence of an agglomerate in the organ are as follows:

• dull pain that increases with food consumption (pain disappears after 1.5 hours);
• instant saturation with a small amount of food;
• heaviness in the epigastrium;
• constant nausea;
• vomiting after a meal;
• belching with a sharp, offensive odor.

Large bezoars in the stomach are more pronounced in the form of:

• increased incidence of acute respiratory viral infections, acute respiratory infections against the background of a decrease in immunity;
• exacerbation of other chronic pathologies;
• severe weight loss;
• rapid overwork, falling performance;
• general weakness;
• fragility of nails, crumbling of tooth enamel against the background of beriberi;
• unhealthy complexion.

If the bezoar is pinched in the exit zone of the stomach, acute symptoms, characterized by cramping pain with repeated, debilitating vomiting.