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Tuesday, May 6, 2014

Information about Bezoars and a Personal Update

So the PCP and GI diagnosed me with a bezoar last week. According to the Mayo Clinic,

A bezoar (BE-zor) is a solid mass of indigestible material that accumulates in your digestive tract, sometimes causing a blockage. Bezoars usually form in the stomach, sometimes in the small intestine or, rarely, the large intestine. They can occur in children and adults.

Bezoars occur most often in people with certain risk factors, including if you:

Had gastric surgery that results in delayed stomach emptying
Have decreased stomach size or reduced stomach acid production
Have diabetes or end-stage kidney disease
Receive breathing help with mechanical ventilation

One type of bezoar (trichobezoar) may occur in people with psychiatric illness or developmental disabilities.



Bezoars are classified according to the material that forms them:

Phytobezoars are composed of indigestible food fibers, such as cellulose. These fibers occur in fruits and vegetables, including celery, pumpkin, prunes, raisins, leeks, beets, persimmons and sunflower-seed shells.

Phytobezoars are the most common type of bezoar.

Trichobezoars are composed of hair or hair-like fibers, such as carpet or clothing fibers. In severe cases, known as "Rapunzel's syndrome," the compacted fibers can fill the stomach with a tail extending into the small intestine. Rapunzel's syndrome is most common in adolescent girls.

Pharmacobezoars are composed of medications that don't properly dissolve in your digestive tract.

Bezoars can cause lack of appetite, nausea, vomiting, weight loss and a feeling of fullness after eating only a little food. Bezoars can also cause gastric ulcers, intestinal bleeding and obstruction, leading to tissue death (gangrene) in a portion of the digestive tract.

Small bezoars may pass through the digestive tract on their own or after you take medication to help dissolve the mass. Severe cases, especially large trichobezoars, often require surgery.

If you don't have one of the risk factors for bezoars, you're not likely to develop them. If you are at risk, reducing your intake of foods with high amounts of indigestible cellulose may reduce your risk.

A bezoar in someone's hand. Image courtesy of: http://www.bezoarmustikapearls.com/images/dewa1thumb.JPG


History of the Bezoar, according to Wikipedia:

Bezoars were sought because they were believed to have the power of a universal antidote against any poison. It was believed that a drinking glass which contained a bezoar would neutralize any poison poured into it. The word "bezoar" comes from the Persian pād-zahr (پادزهر), which literally means "antidote".

The Andalusian physician Ibn Zuhr (d. 1161), known in the West as Avenzoar, is thought to have made the earliest description of bezoar stones as medicinal items. Extensive reference to it is also to be found in the Picatrix, which may be earlier.

In 1575, the surgeon Ambroise Paré described an experiment to test the properties of the bezoar stone. At the time, the bezoar stone was deemed to be able to cure the effects of any poison, but Paré believed this was impossible. It happened that a cook at King's court was caught stealing fine silver cutlery and was sentenced to death by hanging. The cook agreed to be poisoned instead. Ambroise Paré then used the bezoar stone to no great avail, as the cook died in agony seven hours later. Paré had proved that the bezoar stone could not cure all poisons as was commonly believed at the time.

Modern examinations of the properties of bezoars by Gustaf Arrhenius and Andrew A. Benson of the Scripps Institution of Oceanography have shown that they could, when immersed in an arsenic-laced solution, remove the poison. The toxic compounds in arsenic are arsenate and arsenite. Each is acted upon differently, but effectively, by bezoar stones. Arsenate is removed by being exchanged for phosphate in the mineral brushite, a crystalline structure found in the stones. Arsenite is found to bond to sulfur compounds in the protein of degraded hair, which is a key component in bezoars.

A famous case in the common law of England (Chandelor v Lopus, 79 Eng Rep. 3, Cro. Jac. 4, Eng. Ct. Exch. 1603) announced the rule of caveat emptor, "let the buyer beware", if the goods they purchased are not in fact genuine and effective. The case concerned a purchaser who sued for the return of the purchase price of an allegedly fraudulent bezoar. (How the plaintiff discovered the bezoar did not work is not discussed in the report.)

The Merck Manual of Diagnosis and Therapy notes that consumption of unripened persimmons has been identified as causing epidemics of intestinal bezoars, and that up to 90% of bezoars that occur from eating too much of the fruit require surgery for removal.

A 2013 review of 3 databases identified 24 publications presenting 46 patients treated with Coca-Cola for phytobezoars. The cola was administered in doses of 500 mL to up to 3000 mL over 24 hours, orally or by gastric lavage. A total of 91.3% of patients had complete resolution after treatment with Coca-Cola: 50% after a single treatment, others requiring the cola plus endoscopic removal. Surgical removal was resorted to in four patients.

People used to make potions with bezoars as they were thought to ward off evil and used as antidotes. Image courtesy of: http://upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Bezoare.jpg/250px-Bezoare.jpg


Gastric Surgery and Bezoars:

To read more on this amazing published paper, please visit: http://link.springer.com/article/10.1007%2FBF01299861#page-1.




My Struggle:


My doctor told me that medications will dissolve it but has yet to call them in. I've been drinking soda because I've read that it will help dissolve the bezoar. My PCP noticed something sketchy on my x-ray, and then the GI confirmed it once he looked at it. My vitamin D is really low, according to my blood work, so they're going to call in injections for me since I'm not handling anything by mouth hardly at all right now. I've been laying outside, trying to soak up some sun. I have really intense stomach pain and I keep vomiting. No food is staying down and now I'm having issues with liquids, too. I think I'm going to make an appointment with my GI. I can't go on living like this, something has to be done. He mentioned a version of the gastric bypass that he wants to do on me. He thinks it will help but I'm still weighing the pros and cons of having the surgery.

To pass the time tonight, and to keep my mind off of the pain, I started making a website. I wanted to have all of my GP things in once place - my resources/links, events, pictures, my Facebook Page (Emily's Stomach, which I want to get more likes for), a donation button to help me and my friends with medical bills), and the latest GP news. I've been thinking of making a website for a long time, but I haven't had time to do it. So, I sat down tonight, and in between bouts of vomiting, I've created it! I also made a logo that I might put on t-shirts with a gastroparesis design to fund raise money.


My Website is: https://emily-scherer.squarespace.com/

My blog entries will now be posted on my website. I also linked, at the bottom of the pages, to my tumblr account, my pinterest board, my personal Facebook, etc if you would like to follow me and/or read things on there as well.

Here is my logo that I designed:


I think I might do what my friend Melissa has done and make business cards with my logo, website, and blog on it. That way, I can help spread awareness. My goal is to have my own GP store so that I can help others with the proceeds in the future. It's been an idea that I've been thinking about for a long time. I'm just not artistic though, which means, I would have to depend on the designs of my friends.

Speaking of friends, I have so many friends who are struggling with medical bills that I really want to help. I also wouldn't mind having some extra money to put towards my own medical bills. GP is expensive. I need to find a charity to link the donate button on my website to, I guess. I'll have to remember to do that in the morning, pending I actually get some sleep. I've been vomiting so much tonight that I pulled a muscle in my back and in my abdomen. I have been violently projectile vomiting but I haven't eaten anything! So, it's just bile... and that is making my throat swell like I have strep.

I'm on a new anxiety medication, so I hope that helps. I'm really anxious and nervous about my website. I want people to use it as a resource. I want to put great information on there so that people will find it useful. All I have ever wanted was to help others. I hope I can do that by putting the latest news and resources on the site. I have also put pictures up that I've gathered over the past two years with various projects. I want people to see us and to understand GP. Sometimes, it's not real to someone unless they see a picture. I want all of my gp family to know that I think they're beautiful and brave for sharing their pictures.

That reminds me, I need to do another picture request on Emily's Stomach on Facebook (www.facebook.com/emilysstomach). I want family members, co-workers, and others to post pictures of themselves supporting those with GP. I don't have a photo album like that that I'm allowed to use, even though I've worked on that project in the past. I want to post those on my website to show others that people do care, even if they may not know you. It means a lot to us who suffer daily. Sometimes, we desperately need that smile, you know?

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