Foreign Body Ingestion

WHAT YOU SHOULD KNOW:

  • Foreign body ingestion is the swallowing of an object other than food. This commonly happens in adults with mental health problems, including those affected by drugs or alcohol. Prisoners often swallow objects on purpose in the hope that they will be transferred to a hospital. Once an object is swallowed, it may get stuck in the esophagus or get trapped in the stomach. Swallowed objects usually pass through the entire digestive tract and out of the anus (rear end) without problems. Foreign bodies may include coins, pins, seeds, toothpicks, hair, or fish or animal bone.
    Picture of a normal digestive system


  • Pain in the neck, throat, chest, or abdomen (belly) may be symptoms of foreign body ingestion. You may have trouble swallowing, choking, gagging, vomiting (throwing up), or drooling. You may also have breathing problems, such as coughing or wheezing (high-pitched sound when breathing). Tests, such as barium swallow, computerized tomography (CT) scan, endoscopy, or x-rays may be needed for diagnosis. Treatment will depend on the object's type and size and how long it has been inside the body. You may need to have a procedure or surgery done to remove the foreign body. Your caregiver may suggest watchful waiting, until the object is passed out in your bowel movement. With treatment and care the foreign body will come out and more serious problems can be prevented.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Removal of an ingested foreign body may cause unpleasant effects. The esophagus may be scraped, scratched, or injured. The object accidently may go into your airway and this may be life-threatening. Surgery has a risk of bleeding and infection. A foreign body left in the body for a long time may make your symptoms worse. If the foreign body is not removed, it may cause an infection, irritation, swelling, or bleeding. It may block the bowel or cause tears with leakage of the bowel's contents inside the abdomen. The foreign body itself may contain chemicals which may be poisonous. Ask your caregiver if you have questions about your condition and its treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Glucagon: This medicine helps relax the muscles in the lower part of the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. Relaxing your esophagus is helpful if there is an object stuck in it.

  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

  • Sedative: This medicine is given to help you stay calm and relaxed.

Tests:

You may have any of the following:

  • Barium swallow: This test is an x-ray of your throat and esophagus, the tube connecting your throat to your stomach. This test may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. Follow the instructions of your caregiver before and after the test.

  • Computerized tomography scan: This test is also called a CT scan. A special x-ray machine uses a computer to take pictures of your digestive tract. You may be given dye by mouth or in an IV before the pictures are taken. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

  • Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.

  • Fluoroscopy: This is a special type of x-ray that shows movement of joints, organs, and parts of the body. Body parts are shown on a screen for the caregiver. This test may be used to make sure the catheter is being placed correctly.

  • Upper GI x-rays: During an upper GI series, an x-ray machine is used to take pictures of your stomach and intestines (bowel). You may be given a chalky liquid to drink before the pictures are taken. This liquid helps your stomach and intestines show up better on the x-rays. An upper GI series can show if you have an ulcer, a blocked intestine, or other problems.

  • X-rays: X-rays of different parts of your body may be taken. These may include the neck, chest (lungs and heart), or abdomen. X-rays may help caregivers look for the foreign body or signs of other problems. You may need to have more than one x-ray.

Treatment options:

Removal of the foreign body may be done using any of the following:

  • Bougienage: Caregivers insert a thin tube into the esophagus to widen it. They then push the object into the stomach using another instrument. Bougienage is done if the object is smooth and blunt, and likely to be passed out the body. This may also be done if the object was swallowed within the past 24 hours.

  • Endoscopy: Using a scope with a camera, caregivers look for the foreign body and remove it using different instruments. Objects may be grasped using forceps or caught using a net. If the object to be taken out is sharp or pointed, it may be pulled back. Caregivers may also treat other problems, such as bleeding. Endoscopy may also be used to take out an object that cannot go past the stomach.

  • Foley catheter: Caregivers insert a catheter (rubber tube) into the mouth or nose until it goes past the object. With fluoroscopy (a special type of x-ray) as a guide, the balloon at the end of the catheter is filled, and gently pulled out. This may be done if the object is smooth or blunt, such as a coin. A catheter may be used when the object was swallowed within the past 24 hours.

  • Surgery: You may need surgery if many objects were swallowed, or if the swallowed object was large. This may also be done to look for an injury or problem caused by the foreign body. Caregivers may also repair or treat the injury or problem during surgery.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Foreign Body Ingestion (Inpatient Care)

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