Health Library Swallowed ObjectsFrom Healthwise

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.

• Unconsciousness develops or you fear the person is nearing unconsciousness.
• Signs of choking are present. The person cannot cry, talk, or breathe; is turning blue or dusky; or is grasping his or her throat. Have someone call 911 while you try a choking rescue procedure ( Heimlich maneuver in adults and children older than 1 year or back blows in babies younger than 1 year).
• Moderate to severe difficulty breathing occurs:
  • In a child.
  • In an adult or older child.
• Signs of shock are present:
  • In a child.
  • In an adult or older child.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

	Yes	Have you swallowed a button disc battery or magnet?
When to See a Doctor See significance of swallowing a button disc battery or magnet if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have you swallowed a button disc battery? Do not try to cause vomiting. Do not eat or drink anything until you have talked with your doctor. If you are unable to reach your doctor immediately, go directly to the nearest hospital emergency department. Medical treatment is usually needed within 1 hour of swallowing a battery. Yes Have you swallowed one or more magnets? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you wheezing, coughing, or having troubled or noisy breathing after swallowing or inhaling an object?
When to See a Doctor See significance of wheezing, difficult or noisy breathing, or coughing after swallowing or inhaling an object if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Note: Do not eat or drink anything until you have talked with your doctor. Yes Are you having mild breathing problems or noisy breathing? Yes Are you coughing or wheezing? Yes Have you coughed up any blood after a choking episode? Call your health professional today if you answer "Yes" to any of the following questions. Yes Has wheezing, noisy breathing, or coughing developed within a few days of a choking episode? Yes Have you coughed up blood-streaked sputum after a choking episode? Yes Have you been gagging or had trouble swallowing after a choking episode? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pain in your throat, chest, or belly after swallowing or inhaling an object?
When to See a Doctor See significance of pain in the throat, chest, or belly after swallowing or inhaling an object if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Note: Do not eat or drink anything until you have talked with your doctor. Yes Do you have moderate to severe pain in your throat, chest, or belly after swallowing or inhaling an object? Call your health professional today if you answer "Yes" to the following question. Yes Have you had mild pain in your throat, chest, or belly for 1 hour or longer after swallowing or inhaling an object? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Have you swallowed a sharp, long, or large object?
When to See a Doctor See significance of swallowing a sharp, long, or large object if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Note: Do not eat or drink anything until you have talked with your doctor. Yes Have you swallowed a sharp object, such as an open safety pin, a straight pin, bone, toothpick, needle, razor blade, or broken thermometer? Yes Have you swallowed a long object? A long object is: 2 in. (5 cm) or longer for adults and older children. 1.25 in. (3 cm) or longer for babies and small children. You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you swallowed a large object that has not passed in your stool within 7 days? A large object is: 1 in. (2.5 cm) in diameter or larger in adults or older children. 0.75 in. (2 cm) in diameter or larger in babies and small children. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you have an object stuck in your throat?
When to See a Doctor See significance of an object stuck in the throat if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Note: Do not eat or drink anything until you have talked with your doctor. Yes Have you vomited a moderate to large amount of blood or material that looks like coffee grounds? Yes Are you drooling and unable to swallow? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you vomited more than once after swallowing an object? Yes Are you having trouble swallowing after swallowing an object? Yes Have you been gagging after swallowing an object? Yes Do you still feel like something is stuck in your throat or esophagus after swallowing an object, and the feeling has not gone away after 30 to 60 minutes of home treatment? Yes Have you swallowed a pill that feels like it got stuck, and the feeling has not gone away after 30 to 60 minutes of home treatment? Yes After swallowing an object, has your child refused to eat solid food, but he or she does not have other symptoms? Yes After swallowing an object, has your baby started to drool more than usual, but he or she is still eating and drinking normally? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Have you had any changes in your bowel movements after swallowing an object?
When to See a Doctor See significance of changes in bowel movements if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have you had a bowel movement that is mostly blood? Yes Have you had 2 or more bowel movements where less than half of the stool is blood? Yes Have you had 2 or more tarry bowel movements? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had 1 tarry bowel movement? Yes Have you had 1 bowel movement where less than half of the stool looks bloody? Yes Do you have bleeding from the rectum that is turning the toilet water red? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had new diarrhea or constipation for 3 days or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Has a swallowed object not passed in your stool within 7 days?
When to See a Doctor See significance of an object not passing within 7 days if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Have you been unable to find a swallowed object in your stool within 7 days of swallowing the object, but you do not have other symptoms? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Were back blows or the Heimlich maneuver used to dislodge the food or object?
When to See a Doctor See significance of using back blows or the Heimlich maneuver if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Were back blows or the Heimlich maneuver used to dislodge the food or object, but you do not have any symptoms now? Note: If you do not have any symptoms now, a visit to your doctor may not be needed. Let your doctor know that back blows or the Heimlich maneuver was used to dislodge food or an object. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

The following home treatment may help relieve discomfort after you swallow or inhale an object.

• Do not cause (induce) vomiting unless your doctor or the poison control center specifically instructs you to do so. Vomiting could cause you to inhale (aspirate) the object into your windpipe or lungs.
• Drink liquids. If swallowing liquids is easy, try eating soft bread or a banana. If eating soft bread or a banana is easy, try adding other foods. Fruits, vegetables, and whole grains may help move the swallowed object through the digestive tract.
  • Continue to drink more liquids until the object has passed in your stool. Extra fluid will help the object move through the digestive tract. The object should pass within 7 days.
  • Watch your stools to see if the object has passed. Do not use a laxative unless your doctor tells you to.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• New symptoms develop, such as:
  • Fever.
  • Shortness of breath, wheezing, or coughing.
  • Pain in the neck, chest, or abdomen.
  • Vomiting, especially vomit that contains blood.
  • Blood in the stool, such as red, black, or tarry stools.
  • Constipation or diarrhea.
• The swallowed object does not pass in the stool in 7 days.
• Your symptoms become more severe or more frequent.

To prevent children younger than 4 years from swallowing or inhaling objects:

• Carefully supervise young children.
• Keep small items out of your child's reach.
• Teach children not to put anything other than food in their mouths.
• Do not give children foods that may cause choking. These include hard, smooth, or chewy foods that must be chewed with a grinding motion or foods that are round and can easily get stuck in the throat. These types of food are more likely to be swallowed improperly or inhaled.
• Have children, especially toddlers, sit down to eat their food.
• Cut food into small pea-sized pieces.
• Do not feed your child while he or she is crying or breathing rapidly.
• Discourage talking, laughing, or playing while your child has food or beverages in his or her mouth.
• Do not give young children small objects that may cause choking, such as marbles or jacks.
• Look for age guidelines when selecting toys for children.
  • Do not let your child play with a toy if he or she is younger than the recommended age for the toy.
  • The safest toys for small children are at least 1.25 in. (3 cm) around or 2.25 in. (6 cm) in length.

For more information about how to prevent accidental poisoning, see the topic Poisoning. Keep the poison control center number for your area readily available.

Practice the following suggestions when eating and teach them to your children. Children may copy your behavior.

• Cut your food into small pieces.
• Eat small bites slowly and carefully, and chew your food thoroughly.
• Do not laugh or talk with food in your mouth.
• Do not eat or drink while you are involved in another activity, such as driving.
• Do not hold objects such as pins, nails, and toothpicks in your mouth and lips.
• Avoid excessive drinking of alcohol while eating.

To be prepared for a choking emergency, take an approved first aid course such as those that are sponsored by the American Heart Association or the American Red Cross.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What was swallowed or inhaled? What was the size of the object?
• When did it happen?
• What are your main symptoms? How have the symptoms changed since swallowing or inhaling the object?
• Did your symptoms come on gradually or suddenly?
• Have you had a change in your bowel habits?
• What home treatment measures have you tried? Did they help?
• Do you have any health risks?

• Abdominal Pain, Age 12 and Older
• Chest Pain
• Choking Rescue Procedure (Heimlich Maneuver)
• Confusion, Memory Loss, and Altered Alertness
• Constipation, Age 11 and Younger
• Constipation, Age 12 and Older
• Crying, Age 3 and Younger
• Dealing With Emergencies
• Diarrhea, Age 11 and Younger
• Diarrhea, Age 12 and Older
• Nausea and Vomiting, Age 4 and Older
• Poisoning
• Respiratory Problems, Age 11 and Younger
• Respiratory Problems, Age 12 and Older
• Shock
• Sore Throat
• Vomiting, Age 3 and Younger

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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