Experts warn that swallowing gum could lead to a strange and disturbing medical condition.
It can build up in the digestive tract and harden, forming a “stone-like mass” called a bezoar, they say. Chewing on other indigestible matter, such as hair, can also increase the risk.
In a case report published this month by Ecuadorian doctors, a 24-year-old woman underwent surgery to remove a colossal 16-inch (40-centimeter) mass of hair, about the size of a beach ball, from her abdomen.
In the UK, there was a similar case of a seven-year-old girl from Newcastle who had a clump of hair the size of a cricket ball removed from her stomach, said Dr Dan Baumgardt, an expert in pharmacology and neuroscience at the University of Bristol.
While eating fruits and vegetables is generally good for you, bezoars can sometimes form in the indigestible parts of these foods, such as cellulose.
Dr. Baumgardt said it wasn’t just hair that could form the basis of a bezoar, but chewing gum was also a culprit (stock image)
Writing for the website, The conversationsaid Dr. Baumgardt Persimmons, especially unripe ones, tend to form bezoars due to their high content of tannin, a chemical found naturally in plants.
But Dr. Baumgardt added that other foods and even non-foods also cause them to form, although the cases were generally rare.
‘Fiber from fruits and vegetables, milk, medications and chewing gum (such as swallowed gum) can form an indigestible mass in the stomach, while eating inorganic materials such as paper, polystyrene and plastic can also cause bezoars,’ he said.
The compulsive consumption of non-edible things such as hair, paper and sand is medically called pica.
Young children and adults with learning disabilities are among those most likely to develop pica. Adults who are under mental stress or have an iron or zinc deficiency in their diet can also sometimes develop it.
Pregnant women can also develop pica. It is thought that this is a response to their body’s need for certain nutrients.
According to Dr. Baumgardt, many bezoars have a stone appearance, but some, particularly hers, look more like a “braid.” This gave rise to the term “Rapunzel syndrome,” named after the fairytale princess with long hair.
Bezoars can remain undetected in the digestive tract for years. They do not cause symptoms that would alert doctors or family members to their presence unless they block or interfere with normal organ function.
However, they can cause a host of problems, including nausea, abdominal pain, vomiting, stomach ulcers, and even internal bleeding.
Persimmons, especially unripe ones, tend to form bezoars because of their high tannin content, a chemical found naturally in plants.
A substance often used to soften bezoars for further intervention is dark soft drinks such as Coca-Cola or Pepsi
According to Dr. Baumgardt, options for removal in these circumstances include an endoscope: a small instrument attached to a flexible camera, if it is small enough.
Larger bezoars may require swallowing a solution to dissolve the material it is made of, or surgery. Options for these larger ones depend on the material ingested and where exactly the bezoar is located within the patient.
A substance often used to soften bezoars for further handling is dark soft drinks such as Coca-Cola and Pepsi.
According to a 2021 article published in Practical Gastroenterology, the soft drinks’ mild acidity and carbon dioxide help break down some types of bezoars.
This is usually done by giving a patient three liters to drink within 24 hours.
Systematic medical reviews of the technique have shown that these types of soft drinks are successful in only 23 to 60.6 percent of cases, depending on the type of bezoar. Nevertheless, this procedure is often attempted because of its low cost and low risk.
Dr. Baumgardt advises people who are concerned about or susceptible to bezoars to avoid the following foods and behaviors.
“Avoid higher-risk foods such as persimmons, celery, pumpkin, plums and sunflower seed husks – and chew your food thoroughly before swallowing. Avoid swallowing indigestible, non-edible items, including hair, and seek medical advice if you are concerned about the condition pica,” he said.
Estimates of the number of bezoars vary, but they are considered very rare.
Some studies estimate the prevalence among the population at 0.07 to 0.4 percent, which is about one in 250 people or less than one in 1,000.
Others claim that most centers specializing in gastroenterology (treatment of diseases of the digestive system) treat an average of only 2.5 cases per year. In countries where persimmons are widely consumed, this number can reach 16.5 per year.