Bezoars are an uncommon cause of intestinal obstruction and may be managed using several approaches. Because recurrence can occur, invasive or surgical treatments should not be considered first-time when conservative options are feasible. We report the case of a 67-year-old man with a previously asymptomatic giant gastric phytobezoar who developed subocclusive symptoms. A review of the literature was performed to evaluate available treatment strategies, as no standard therapy exists to date for giant bezoars. A conservative approach was selected using an oral enzyme complex (Digeston Plus®) containing digestive enzymes and probiotic bacteria. The patient completed a three-month treatment course, leading to symptom resolution and near-complete dissolution of the bezoar without the need of invasive intervention.
Sabatella et al. (Mon,) studied this question.