Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · 2007 · 18 citations · 20 references
MedicineInternal MedicinePharmacotherapyEnzymologyGastroenterologyHepatologyGastrointestinal DiseaseLaparoscopic SurgeryDigestive ComplicationsDigestive System ExaminationFollow-up EndoscopyGallbladder UltrasonographyHiatal Hernia RepairLaparoscopic CholecystectomyProteolytic Enzyme ActivationProteolytic Enzyme Activity
A 58-year-old man went to his physician with complaints of midepigastric pain, flatulence, belching, and shortness of breath. During a physical examination, the patient was in no acute distress. The patient underwent an ultrasound examination, which revealed cholelithiasis, a laparoscopic cholecystectomy, which revealed chronic gallbladder disease, and esophagogastroduodenoscopy, which revealed gastritis, a hiatal hernia, and a phytobezoar. To treat the bezoar, the patient was given Adolph's Meat Tenderizer 1 teaspoonful in 8 oz of water before each meal for 7 days. This product contains papain, a proteolytic enzyme, that is thought to cleave protein linkages within bezoars. The patient's symptoms resolved with no adverse events reported, and follow-up endoscopy revealed resolution of the phytobezoar. Although a few other agents are used to treat phytobezoars, little clinical data exist on their safety and effectiveness. Adolph's Meat Tenderizer appears to be a safe and effective treatment for patients with a phytobezoar.
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Update on the medicinal management of phytobezoars.
Pamela Walker-Renard · PubMed · 1993 · 88 citations
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Warren D. Holloway, S P Lee, G I Nicholson · PubMed · 1980 · 58 citations
Acetylcysteine in Removal of Bezoar
Henry A. Schlang · JAMA · 1970 · 47 citations
Medicine, Internal Medicine, Surgery +16
Endoscopic and Enzymatic Treatment of Gastric Bezoar with Acetylcysteine
F. G. Silva, C. R. Gonçalves, H. Vasconcelos et al. · Endoscopy · 2002 · 37 citations · Full text
The Successful Medical Management of a Phytobezoar
David S. Dann · Archives of Internal Medicine · 1959 · 36 citations