—Dr Puet reminds us that some nonpersimmon phytobezoars have been reported to be composed of orange pith. In addition to this food, other citrus fruits and vegetables have been associated with bezoar formation.1 Although we did not attempt to identify the specific food composition in the patients with phytobezoar described in our study, we support the belief that phytobezoars can be composed of undigested plant fiber from a variety of sources. Ingestion of such plant fibers, particularly by patients with abnormal gastric motility, seems to increase the risk of phytobezoar development. We agree with Dr Puet's suggestion that patients at risk for phytobezoar formation should avoid the pulp of citrus fruits.
Zarling EJ, Thompson LE. Nonpersimmon Gastric Phytobezoar-Reply. Arch Intern Med. 1985;145(1):181. doi:10.1001/archinte.1985.00360010229053