Phytobezoar in an Addict: The Cotton-Picking Stomach Syndrome

To the Editor:—  A patient is presented who manifested signs of intermittent gastric obstruction due to the ingestion of absorbent cotton pledgets used in association with his narcotics habit.Recent publications^1,2 have discussed the medical complications of narcotics addiction. The described patient presents an unusual complication of the habits of the addict.

Report of a Case:  A 25-year-old man presented with a four-month history of episodes which began by belching a foul-smelling material, persisting for 24 hours, and followed by copious vomiting of malodorous material in which particles of food ingested the previous day were sometimes identifiable. There was no associated abdominal pain, preceding nausea, and no similar history or history of gastrointestinal disease in general. After the vomiting the patient felt quite well until the following week, at which time the episode would be repeated. He had been withdrawn from heroin previously and was taking methadone (Dolophine) hydrochloride