Risk factors for formation of a pharmacobezoar:
(1) suicide attempt
(2) drug abuse (taking a handful of pills)
(3) illicit pill smuggling (body packing)
(4) taking multiple controlled-release formulations, especially with decreased gastric emptying or bowel motility
(5) child overdosage, especially with iron formulations
An essential feature is that the formulation does not dissolve readily.
Complications:
(1) bowel obstruction
(2) continued release of the chemical or drug
Management:
(1) Gastric bezoars can be retrieved by endoscopy.
(2) Bezoars causing bowel obstruction need to be surgically removed.
(3) Activated charcoal or whole bowel irrigation can be used to decontaminate the bowel.
(4) The bezoar may need to be surgically removed if other means of gut decontamination cannot be used.
