Swallowed Objects

Topic Overview

When you swallow food, liquid, or an object, what is swallowed passes from your mouth through your throat and esophagus into your stomach. A swallowed object will usually pass through the rest of your digestive tract without problems and show up in your stool in a few days. If food or a nonfood item gets stuck along the way, a problem may develop that will require a visit to a doctor.

Sometimes when you try to swallow, the swallowed substance "goes down the wrong way" and gets inhaled into your windpipe or lungs (aspirated). This occurs most often in children who are younger than 3 years and in adults who are older than age 50. When you do inhale a substance, coughing is a normal reaction of the body to clear the throat and windpipe. The cough is helpful and may clear up the problem. Inhaling a substance into your lungs can cause a lung inflammation and infection (aspiration pneumonia).

The situation may be more serious when:

• Signs of choking (complete airway obstruction) are present. When the windpipe is blocked, air cannot move in and out of the lungs and the person cannot talk. A blocked windpipe is a life-threatening emergency.
  • The choking rescue procedure (Heimlich maneuver) is used to clear an obstruction in adults and children older than 1 year.
  • Rescue back blows and abdominal thrusts are used in babies younger than 1 year.
• Signs of a partially blocked windpipe are present. When the windpipe is partially blocked, some air can still move in and out of the lungs. Coughing will often pop out the food or object and relieve the symptoms. The choking rescue procedure is not recommended when the windpipe is partially blocked.
• An object is stuck in the esophagus.
• A poisonous object has been swallowed. Go to the topic Poisoning if a known or suspected poisonous substance (such as a wild mushroom, plant, or chemical) has been swallowed.
• A potentially poisonous object, such as a condom filled with illegal drugs, has been swallowed.
• A button disc battery has been swallowed.
• A swallowed object doesn't show up in the stool within 7 days.

Approximately 80% to 90% of swallowed objects pass through the gastrointestinal tract without problems. However, some types of objects can cause more serious problems when they are swallowed. These include:

• Sharp objects, such as open safety pins, bones, toothpicks, needles, razor blades, or broken thermometers.
• Long objects.
  • In adults and older children, an object 2 in. (5 cm) or longer
  • In babies and small children, an object 1.25 in. (3 cm) or longer
• Large objects that may get stuck in the digestive tract and require removal.
  • In adults and older children, objects that are 1 in. (2.5 cm) or larger in diameter
  • In babies and small children, objects that are 0.75 in. (2 cm) or larger in diameter

Your doctor may recommend tests such as an X-ray, endoscopy, or barium swallow to help find the object if it doesn't come out in the stool, or if an inhaled object is not coughed out. See an X-ray of a swallowed object. A special metal detector (not the same kind that people use in their yards) might be used to locate a metallic object, such as a coin, inside the body. Your doctor may then recommend a procedure to remove the object or may simply encourage you to continue to check the stool for the passage of the object.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

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Author:	Jan Nissl, RN, BS	Last Updated: October 5, 2007
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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