Foreign Body Ingestion

GENERAL INFORMATION:

What is foreign body ingestion? 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. The esophagus is the tube that connects the mouth to the stomach. Swallowed objects usually pass through the entire digestive tract and out of the anus (rear end) without problems.

What causes foreign body ingestion? Foreign body ingestion may happen by accident or be done on purpose. Objects may be blunt, sharp, pointed, or poisonous. These may include coins, safety pins, needles, school supplies, tacks, seeds, toothpicks, or batteries. You may swallow a fish bone or an animal bone while eating. Adults wearing dentures (false teeth) may swallow them by accident.

What are the signs and symptoms of foreign body ingestion? There may be a feeling that something is in your throat or neck. This may be felt even after removal of the object if the lining of your esophagus was injured. You may have pain in the neck, throat, chest, or abdomen (stomach). Trouble swallowing, choking, gagging, vomiting (throwing up), or drooling saliva may also happen. You may also have breathing problems, such as coughing or wheezing (high-pitched sound when breathing).

How is foreign body ingestion diagnosed?

• 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 body. It may be used to look at 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 has 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.
  
  
• Metal detectors: This may be used to look for metallic objects in the body, such as coins.
  
  
• 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.

How is foreign body ingestion treated? Treatment will depend on the type and size of foreign body that was swallowed. Treatment also depends on how long and how far the foreign body is in the digestive tract. Caregivers usually advise watchful waiting to treat foreign body ingestion. Once the object is in the stomach, passing it out through the anus may be more likely. Passing out the object may take many days or weeks. You may also have any of the following:

• Medicines: You may be given sedatives and pain medicines to help you stay comfortable, calm, and relaxed. Caregivers may give you medicines to relax the muscles in the lower part of your esophagus. Antibiotic medicine may also be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Procedures: Removal of the object may be needed if the object is stuck in the esophagus. This is also done if the object is sharp or pointed and may cause serious problems. Removing the object may be done using any of the following:
  
  
  • Bougienage: Caregivers will insert a thin tube into the esophagus to widen it. They will 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: A scope with a camera is passed through your mouth and into your upper digestive tract. Caregivers look for the foreign body and remove it through the scope 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 out your mouth. 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.

Where can I find more information? Contact the following for more information:

• American Society for Gastrointestinal Endoscopy (ASGE)
  1520 Kensington Road
  Oak Brook, IL 60523
  Phone: 1-630-573-0600
  Web Address: http://www.asge.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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