Perdiem is a bulk laxative (mostly psyllium) formulated as granules; these granules can adhere together and cause esophageal impaction and gastric bezoars. I have reported three cases of esophageal impaction caused by Perdiem. Although endoscopic manipulation is the currently favored treatment, bougienage relieved these impactions easily. One patient also had a gastric bezoar. Doctors and patients need to be aware of this potential complication from Perdiem.