Premedication using 100 mg simethicone in 100 mL of water improves endoscopic visibility. Addition of N-acetylcysteine to simethicone in 100 mL of water reduces the need for endoscopic flushing. For patients unable to tolerate a large fluid volume, a 5-mL simethicone suspension administered more than 30 min prior to upper endoscopy is suggested.

Bezoars are concretions of foreign matter in the gastrointestinal tract which may cause nonspecific symptoms, including epigastric discomfort, early satiety, and constipation, and rarely gastrointestinal obstruction. We report a case in which the migration of bezoars led to secondary gastrointestinal obstruction. With endoscopy manipulation and chemical dissolution, such as with Coca-Cola, to disintegrate the gastric bezoars, the possibility that fragmented residuals may coalesce in the small intestine causing ileus should be considered when a patient presents with abdominal obstruction symptoms after these procedures. In this condition, abdominal plain film X-ray and computer tomography play important roles in timely diagnosis.

No abstract