March 1985

Nonpersimmon Gastric Phytobezoars

Arch Intern Med. 1985;145(3):577. doi:10.1001/archinte.1985.00360030229054

To the Editor.  —I read with great interest the article of Zarling and Thompson on nonpersimmon gastric phytobezoar in the Archives.1 The fact that nonpersimmon gastric phytobezoars have been shown to differ clinically, and in their evolution, from the persimmon bezoars is an interesting finding and may reflect partially a different pathophysiology.Indeed, the formation of the persimmon phytobezoars necessitates gastric secretions for the agglutination of phlobatannin, whereas no such involvement has been described in the nonpersimmon bezoars. It remains, however, that regardless of clinical differences and severity of complications, gastroparesis, whether surgically induced, metabolically related, or idiopathic, represents a key element in the accrual and progression if not in the recurrence of the bezoar and should be addressed in that perspective. In our article "Metoclopramide in the Treatment of Gastric Bezoars",2 we have shown that properly documented by radioisotope gastric emptying test and endoscopy, gastroparesis and its

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