[Esophageal obstruction caused by dietary fiber from Plantago ovata, a complication preventable by adequate information].
BACKGROUND
Plantago ovata (PO) is widely used as a dietary fiber in the treatment of constipation. A case of esophageal obstruction due to PO is presented. Other published cases are reviewed, and possible risk factors and prevention are discussed.


METHODS
A 41-year-old woman felt chest pain and regurgitation immediately after swallowing a tablespoonful of PO in granules. She kept the granules in her mouth for a few seconds before swallowing them with 250 ml of water. Flexible endoscopy revealed a brown-black consistent mass blocking the inferior esophagus. A mild hiatus hernia was subsequently discovered.


CONCLUSIONS
All the cases found through an unlimited Medline search using key words Plantago, Psyllium, mucilage, bezoars and esophagus, were taking PO in granules. Most of the cases took the granules with insufficient liquid, and some had previous obstructive esophageal disease. PO in powder probably presents a lower risk of esophageal obstruction.
Salguero Molpeceres
O
O
Especialistas en Medicina Familiar y Comunitaria. Area 6. Madrid. Spain. olisalguero@telefonica.net
Seijas Ruiz-Coello
M C
MC
Hernández Núñez
J
J
Caballos Villar
D
D
Díaz Picazo
L
L
Ayerbe García-Monzón
L
L
D000042:Absorption; D000328:Adult; D001630:Bezoars; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000209:etiology*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000009:adverse effects*; D004304:Dosage Forms; D062787:Drug Overdose; D004382:Duodenitis / Q000150:complications; D004630:Emergencies; D016145:Endoscopy, Digestive System; D004943:Esophagogastric Junction; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D010316:Particle Size; D011208:Powders; D011620:Psyllium / Q000008:administration & dosage / Q000009:adverse effects*; D012306:Risk; D012995:Solubility
D002400:Cathartics; D004043:Dietary Fiber; D004304:Dosage Forms; D011208:Powders; D011620:Psyllium