Chewing Gum Bezoars of the Gastrointestinal Tract

Abstract

ABSTRACT. Children have chewed gum since the Stone Age. Black lumps of prehistoric tar with human tooth impressions have been found in Northern Europe dating from ϳ7000 BC (Middle Stone Age) to 2000 BC (Bronze Age). 1The bite impressions suggest that most chewers were between 6 and 15 years of age. The Greeks chewed resin from the mastic tree (mastic gum). North American Indians chewed spruce gum. The first manufacturing patent for chewing gum was issued in 1869 for a natural gum, chicle, derived from the Sopadilla tree, indigenous to Central America. Chewing gum sold today is a mixture of natural and synthetic gums and resins, with added color and flavor sweetened with corn syrup and sugar. Chewing gum is big business. A significant amount of the $21 billion US candy industry sales is from chewing gums, many of which appeal almost exclusively to children. Despite the history and prevalence of gum chewing, the medical literature contains very little information about the adverse effects of chewing gum. In the present report, we briefly review gum-chewing complications and describe three children who developed intestinal tract and esophageal obstruction as a consequence of swallowing gum. Pediatrics 1998;102(2). URL: http://www.pediatrics.org/cgi/content/full/102/2/e22; gum, chewing gum, constipation; fecal mass. CASE REPORTSCase 1

Sunflower Rectal Bezoar Presenting With an Acute Abdomen in a 3-Year-Old Child

“…In children, hair 1Y4 and vegetable matter 5Y7 are the most common causes of beazors, 8 although unusual sources have been reported such as Gummi bears, 9 stones, 10 sponges, 11 rocks, 12 and chewing gum. 13 The most prevalent location for bezoars is the stomach 1,2,14 and small intestine 6,7,15 and less commonly the large intestine. 12,16 Predisposing factors for the development of bezoars include prior gastrointestinal surgery; delayed gastric emptying and/or acid production; significant intake of vegetable or fruit fiber; alteration of dentition and poor mastication of foods 15 ; a history of pica or developmental delay 4,12 ; congenital bands, webs, or adhesions 17 ; and a history of trichotillomania in the case of trichobezoars.…”

Gastric Trichobezoar: An Important Cause of Abdominal Pain Presenting to the Pediatric Emergency Department

“…A variety of miscellaneous materials have been reported to cause bezoar formation in infants and children, including antacids, chewing gum, candy, toilet paper, sponges, and sunflower seeds. [6][7][8][9][10][11] Phytobezoars are the most common type overall, and are classically found in adults with a history of previous gastric surgery, conditions of reduced gastric acidity, poor gastric mixing, and delayed motility. Trichobezoars result from ingestion of human hair as well as hair from dolls or stuffed animals, blanket, and carpet fibers.…”

An unusual cause of postfundoplication vomiting

“…with 4 coins wrapped in gum and lodged in the esophagus [13]. Trichobezoars of the esophagus have not been described in children.…”