- With Mayo Clinic gastroenterologist
Michael F. Picco, M.D.read biographyclose window
Michael F. Picco, M.D.Michael F. Picco, M.D.
Dr. Michael Picco has been with Mayo Clinic since 1999. He is board certified in internal medicine and gastroenterology. Dr. Picco is an assistant professor of medicine at College of Medicine, Mayo Clinic, and a consultant in gastroenterology at Mayo Clinic in Florida.
He has authored numerous publications in the area of gastroenterology, including original research, editorials and textbook chapters. He works with a team of gastroenterologists that takes care of complex gastrointestinal conditions and has a particular interest in diarrheal illnesses and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). He is also active in medical education in training new gastroenterologist and internists.
"Mayo Clinic's website is an invaluable resource for patients and their families," Dr. Picco said. "Informed patients are better able to participate in their own health care. A patient's participation is vital to the treatment of his or her disease. I hope to assist in helping patients understand their digestive problems and current treatments that are offered. This will allow for better communication between patients, their physicians and other health care professionals."
Dr. Picco serves as a reviewer of new research for several medical journals in the area of gastroenterology and is an active member of the American Gastroenterological Association, American College of Gastroenterology and the Crohn's & Colitis Foundation of America. He serves on numerous committees that address physician training, research and clinical practice in gastroenterology, both at Mayo Clinic and at the national level.
"Patients need to know about their disease, what to expect, the latest treatments and side effects so that they can make informed decisions about their health care. Gastrointestinal disease affects not only patients but also their families. My goal is to assure that our website provides accurate, reliable information and resources for patients. We must always provide the latest, most cutting-edge information to assist patients in dealing with their medical problems," Dr. Picco said.
Bezoars: What foods can cause this digestive problem?
I've heard that eating certain foods can cause bezoars. What are bezoars?
from Michael F. Picco, M.D.
A bezoar (BE-zor) is a solid mass of indigestible material that accumulates in your digestive tract, sometimes causing a blockage. Bezoars usually form in the stomach, sometimes in the small intestine or, rarely, the large intestine. They can occur in children and adults.
Bezoars occur most often in people with certain risk factors, including if you:
- Had gastric surgery that results in delayed stomach emptying
- Have decreased stomach size or reduced stomach acid production
- Have diabetes or end-stage kidney disease
- Receive breathing help with mechanical ventilation
One type of bezoar (trichobezoar) may occur in people with psychiatric illness or developmental disabilities.
Bezoars are classified according to the material that forms them:
- Phytobezoars are composed of indigestible food fibers, such as cellulose. These fibers occur in fruits and vegetables, including celery, pumpkin, prunes, raisins, leeks, beets, persimmons and sunflower-seed shells. Phytobezoars are the most common type of bezoar.
- Trichobezoars are composed of hair or hair-like fibers, such as carpet or clothing fibers. In severe cases, known as "Rapunzel's syndrome," the compacted fibers can fill the stomach with a tail extending into the small intestine. Rapunzel's syndrome is most common in adolescent girls.
- Pharmacobezoars are composed of medications that don't properly dissolve in your digestive tract.
Bezoars can cause lack of appetite, nausea, vomiting, weight loss and a feeling of fullness after eating only a little food. Bezoars can also cause gastric ulcers, intestinal bleeding and obstruction, leading to tissue death (gangrene) in a portion of the digestive tract.
Small bezoars may pass through the digestive tract on their own or after you take medication to help dissolve the mass. Severe cases, especially large trichobezoars, often require surgery.
If you don't have one of the risk factors for bezoars, you're not likely to develop them. If you are at risk, reducing your intake of foods with high amounts of indigestible cellulose may reduce your risk.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2&about=true&uniqId=229935664-2192.
- Minty B, et al. Rectal bezoars in children. Canadian Medical Association Journal. 2010;11:182.
- Kansagra A, et al. Rapunzel's syndrome. Digestive Diseases and Sciences. 2010;55:3284.
- Raikar S, et al. Recurrence of Rapunzel's syndrome. The Journal of Pediatrics. 2010;157:343.