Perfil del paciente con hipotiroidismo subclínico en atención primaria / Profile of patients with sub-clinical hypothyroidism in primary care

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[Esophageal obstruction caused by dietary fiber from Plantago ovata, a complication preventable by adequate information]. / Obstrucción esofágica por la fibra dietética Plantago ovata, una complicación prevenible mediante la información.

INTRODUCTION: 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. CASE REPORT: 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. DISCUSSION: 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.