Drinking pineapple juice for undigested food in stomach.

To the Editor, Phytobezoars, concretions of undigested food, are believed to remain silent and resolve spontaneously (1). Patients with symptomatic gastric bezoars usually present with small bowel obstruction (2). Endoscopic fragmentation and extraction with biopsy forceps, Dormia baskets, and polypectomy snares via overtube, which are the main treatment options in recent years, have many side effects, and large-channel gastroscopes are rarely available in endoscopy units. Most popular methods to dissolve bezoars are making lavages by acetylcysteine or cola (1,2). Pineapple juice, which contains bromelain, a proteo-lytic enzyme, was reported as a good choice to dissolve phytobezoars in the literature (3-5). Despite the high success rates and fewer side effects, drinking cola is not always suitable for patients presenting with epigastric discomfort and bloating. For these purposes, we aimed to show the efficacy of drinking pineapple juice in dissolving gastric pre-bezoar formations in seven gastrec-tomized patients. All patients who were referred to our clinic to perform upper gastrointestinal (GI) endoscopy due to histories of gas-trectomy over 10 years and presenting with undigested food endoscopically were included in the study. Upper GI endoscopies were performed by AA and EF in the outpa-All of the patients were asked to drink pineapple juice in the next 3 days until the next upper GI endoscopy. To prevent different usages of pineapple juice, 100% pineapple juice, Dimes® (Izmir, Turkey) 1 liter daily between two endoscopic procedures, preferably after each meal, in divided amounts, was recommended to all patients without any change in dietary intake. The demographic features of the seven patients and the results of the first endoscopic appearances are summarized in Table 1. None of the patients had complaints attributed to undigested food in the stomach, except patient 4, who had a history of surgery due to phytobezoars that induced a small bowel obstruction 6 months before. Other than the second patient, all of the pre-bezoar formations were totally cleaned up. Therapy was unable to go on in patient 2, because he went abroad. Age Gender Type of Location/size of pre-bezoar Success of treatment Patient (years old) (M/ F) surgery formations (Yes/No)