An X-Ray Showing 100 Bubble Tea Pearls in a Teen's Abdomen Has Doctors Very Confused

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A teenager in China reportedly had more than 100 undigested bubble tea pearls in her abdomen, which caused an abdominal blockage and showed up on a CT scan, according to news reports.

But could this really happen?

Although bubble tea pearls can cause constipation, they wouldn't normally show up on a CT scan, experts said.

The 14-year-old girl, who lives in Zhejiang, China, said she had been constipated for five days, wasn't able to eat and was experiencing stomach pain. A CT scan revealed that there were around 100 "unusual spherical shadows" in the girl's abdomen, according to Asia One. [27 Oddest Medical Case Reports]

After speaking with the teen about what she'd eaten recently, doctors concluded that the unusual shadows on the scan were actually undigested bubble tea pearls, which are ordinarily made from tapioca starch. Although the girl claimed to have consumed just one bubble tea five days earlier, her doctors said she would have needed to consume much more than this in order to cause her symptoms.

Eating a lot of tapioca balls could "for sure" cause constipation, said Dr. Lina Felipez, a pediatric gastroenterologist at Nicklaus Children's Hospital in Miami, who wasn't involved in the girl's case.

Tapioca is a very starchy food that's mostly made of carbohydrates. By itself, tapioca likely wouldn't cause significant constipation, Felipez said. But the balls typically contain other additives that can contribute to constipation. In particular, an additive called guar gum may play a role in causing digestive issues — guar gum is a fiber that helps hold the balls together and makes them stickier. Guar gum also expands when it comes in contact with water, Felipez said.

Interestingly, guar gum can be used to treat both constipation and diarrhea, Felipez said. High doses of guar gum can cause a blockage of the esophagus and intestines, according to WebMD.

However, what’s puzzling is that tapioca, guar gum and other ingredients typically used in tapioca balls in the U.S. would not show up on a CT scan. These ingredients aren't "radiopaque," meaning they don't show up on X-rays or CT scans, Felipez said. That's because these ingredients do not block the type of radiation used in X-rays. (Instead, they allow the radiation to pass through, and thus remain invisible on X-rays.)

It's possible that another type of additive used in China was causing the tapioca balls to show up on the CT, she said. But it's unclear what kind of additive this would be.

In 2015, Vice reported that a patient in China saw white dots on their CT scan after consuming bubble tea; and a reporter also saw similar white dots on her CT after consuming a bubble tea from the same shop. At that time, rumors were flying that the pearls were made of old tires and shoes, which was never confirmed.

In the teenage girl's case, she was treated with a laxative and sent home, according to Business Insider.

Originally published on Live Science.

Rachael Rettner

Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.