The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate

Internal Medicine 2026 Open access

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Authors: Katsuma Yamauchi, Aya Kitae, Masayuki Hara, Seiya Sugeta, Keiji Yoneda, Tomohiro Ueda, Kazuhiro Tsuji, Yasutaka Morimoto, Akiko Shibuya, Tomoyuki Ono, Tomoki Nakajima, Norimasa Yoshida
+8 more Miyuki Kitade, Hiroyuki Inagake, Nozomi Yoshioka, Emiko Wada, Hikaru Takayasu, Miki U. Ueda, Risa Ueno, Yoshito Itoh
DOI: 10.2169/internalmedicine.6743-25
Cited by: 1
References: 17

Abstract

Sodium zirconium cyclosilicate hydrate (SZC) is a novel potassium binder that can be administered either orally or via nasogastric tubes. We report the case of a 77-year-old woman who developed a 37-mm gastric bezoar after nasogastric SZC administration during intensive care for acute adrenal insufficiency. Endoscopic removal was performed, and the analysis confirmed that the SZC was the primary constituent. Impaired gastric motility, acidic gastric environment, and limited hydration are likely contributors. This case highlights the potential for SZC-induced gastric bezoar formation in critically ill patients, and underscores the importance of imaging monitoring, careful gastrointestinal management, and the awareness of this potential complication during SZC therapy.

Fields of Study & Subjects

Intestinal and Peritoneal Adhesions Kidney Stones and Urolithiasis Treatments Biliary and Gastrointestinal Fistulas

Publication details

Journal / source
Internal Medicine
Publisher
Japanese Society of Internal Medicine
Volume
65
Issue
17
Pages
2327–2331
Publication date
14 January 2026
Language
EN