The Diet Pill That Worked

To the Editor: At 7 p.m., a middle-aged, obese man with a history of intermittent dysphagia was seen at the emergency room of the Minneapolis Veterans Affairs Medical Center. He reported complete inability to eat or drink for approximately 12 hours. Earlier that morning he had taken a moderate-sized diet tablet composed primarily of guar gum and grapefruit fiber. Shortly thereafter complete dysphagia developed, with prompt regurgitation after any attempted ingestion of a solid or liquid. Endoscopy of the upper gastrointestinal tract revealed a 2-by-3-cm soft, fibrous bezoar impacted in a distal esophageal stricture that was benign and moderately tight.