Epidemiology

Foreign body ingestion and food impaction are common gastrointestinal (GI) problems. Fortunately, >80% of ingested foreign bodies pass through the GI tract without incident. However, sharp/pointed objects (e.g., razorblades, bones, pins, needles, wire, or nails) and objects >2.5 cm in diameter will not pass through the pyloric opening, and objects >6 cm long will not advance through the duodenal loop. High-powered magnets and batteries have also been implicated in complications and are difficult to remove.

Children <15 years old account for 70% to 80% of patients with foreign bodies in the upper GI tract, with the highest incidence in children between 1 and 3 years old. In children with swallowed foreign bodies, there is no sex predominance. Metallic objects are more often found than nonmetallic objects, with coins being the most common object removed from the upper GI tract of children in Western countries.[9][10]​​ One European retrospective study found that patients with foreign body ingestion seen annually increased from 66 in 2005 to 119 in 2017.[11]​ In Asian countries, fish bones are the most common foreign body removed from the upper GI tract of children.[12][13]

An increasing number of cases of ingestion of button batteries and high-powered magnets in children have been reported, likely due to the increased use of these types of batteries in toys and household gadgets.[14][15][16]​ High-powered magnets can cause serious and potentially life-threatening complications, particularly if more than one is ingested, as the magnets can attract each other through the intestinal wall, causing bowel wall ischemia and perforation.[3][17]

In adults, the incidence of accidentally or intentionally swallowing foreign bodies is higher in men than women. Food impaction is the most common cause of upper GI obstruction and is associated with: primary neurologic disorders involving gag reflex impairment (e.g., Parkinson disease, postictal states, post stroke, dementia); use of alcohol/recreational drugs or other centrally acting medications that cause sedation; use of hypnotic or mental depressing agents (e.g., benzodiazepines, narcotics); and esophageal disorders (e.g., eosinophilic esophagitis, Schatzki ring, and peptic strictures). Adults with nonfood foreign bodies have a high incidence of psychiatric pathologies, chemical dependence, or social disturbances.

In 2019, 4923 deaths caused by suffocation following foreign body ingestion (ICD-11 codes PB06, PB07) were reported in the US.[18] Of these deaths, more than 70% (n=3625) occurred in people ages over 65 years.[18]

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