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October 4, 1976

Dissolution of Phytobezoar Using Pineapple Juice

Author Affiliations

Tufts-New England Medical Center Boston

JAMA. 1976;236(14):1578. doi:10.1001/jama.1976.03270150016018

To the Editor.—  We wish to report the successful dissolution of a phytobezoar using unprocessed pineapple juice which contains the proteolytic enzyme bromelain.

Report of a Case.—  A 57-year-old woman underwent hemigastrectomy and bilateral truncal vagotomy for a 1-cm lesser-curvature gastric ulcer that had not healed after eight weeks of intensive medical management. Histopathologic study showed an adenocarcinoma limited to the area under the ulcer. One year later she had no evidence of recurrence and sought to lose weight with a low-calorie diet containing increased amounts of fruits and vegetables. Five months later she noted frequent episodes of vomiting and postprandial epigastric distress. An upper gastrointestinal roentgenographic study showed an 8×13-cm bezoar. A diet low in fiber was initiated immediately. Dissolution with papain (Adolph's Meat Tenderizer) was attempted, but excessive burning discomfort made her stop within two days. She then took bromelain in the form of fresh pine-apple juice; she