Apr 16, 2014

Interviewer: Is it bad enough to go to the emergency room, or isn't it? Find out now. This is "East.R. or Non?" on The Scope. Fourth dimension for another episode of "Eastward.R. or Not?" where you make the call of whether or not you should go to the Due east.R. and and then nosotros'll find out the definitive answer from Dr. Troy Madsen, emergency medicine at University of Utah Hospital. Today'southward E.R. or not, a lot of people like to hang around with toothpicks hanging out of their oral fissure, onetime ranchers, truck drivers, what happens if you swallow a toothpick? E.R. or not?

Dr. Madsen: I would say E.R.

Interviewer: Really?

Dr. Madsen: And the reason for this is you tin can think of these sorts of things in two different categories, and then we're talking well-nigh things that you accidentally swallow, in some cases I've seen where these things take been intentionally swallowed but that's kind of a different upshot entirely.

Interviewer: Okay.

Dr. Madsen: Only either these things are going to be too large to be able to pass through your intestines, or they're going to be precipitous and potentially perforate the intestines.

Interviewer: Okay.

Dr. Madsen: Both of those are problems.

Interviewer: Okay.

Dr. Madsen: And so if it'due south something that'due south too big and obviously that's not an event with a toothpick, this isn't something that is really big, it should exist able to pass without any issues, merely the issue is that it'due south very abrupt, so if nosotros're talking about sharp things, and you know 1 of the large notorious things nosotros see in kids that'due south very concerning is sewing needles, so kind of think of a toothpick like a sewing needle. And then yous think of the intestines, once it gets past the stomach it's working it's way through and the intestines are very long and it'south got a long way to travel, and they're very sparse, and then if it'south something that'southward abrupt information technology could potentially come up against the edge and push through that and perforate it.

Interviewer: Really.

Dr. Madsen: And the reason that's a problem is because you take all sorts of bacteria in the intestines. And the moment that bacteria gets into the abdomen itself, that can be a very serious thing and cause some very serious infections.

Interviewer: So now a lot of times after yous chew on a toothpick for a long time they kind of start turning soft, that wouldn't in your breadbasket go soft and dissolve away?

Dr. Madsen: Yeah, and once again information technology's a tough i. This is actually . . . y'all gave me a tough one here. You really fabricated me recall virtually this because y'all're right. There are dissimilar scenarios where you lot may have kind of chewed on the toothpick and maybe bitten it and in that case it's probably kind of chewed upwards and kind of macerated where it's going to piece of work it's style through without an issue, but if it's something where you've got a abrupt object that is going to stay sharp, in your intestines and potentially perforate it, that's the trouble. And then the reason I kind of say that is it'due south probably worth coming to the E.R., certainly if you're talking almost a plastic sort of toothpick or even annihilation that's more firm, that's not going to deliquesce easily.

Interviewer: Yeah, they have some of those new plastic toothpicks now and those could poke.

Dr. Madsen: Those definitely could and so I would say admittedly there. The woods one is a fiddling flake more of a greyness zone only I say come to the E.R. because information technology'south worth evaluating and talking to our G.I. doctors, our specialists to see what their thoughts are on that.

Interviewer: Certain, considering otherwise information technology could exist serious.

Dr. Madsen: It could be and that's kind of weighing the take a chance benefit. It could potentially be a serious thing. If it's too long to pass, it'southward not going to become through, and the way we think of things that are besides long or too wide, if it'due south longer than say near 5", this is a pencil you've swallowed and nosotros have seen people who have swallowed pencils and they have been intentional-kind of interesting-that's not going to pass. And if information technology's wider than well-nigh 2", so it's something, maybe it'south not 5" long just information technology's wider than 2", that'south not going to laissez passer, not going to get past the stomach.

Interviewer: What's the effect there and so, if it gets stuck up in there?

Dr. Madsen: So if information technology gets stuck and it's correct up there in the stomach, cipher's going to become through. So you're going to get to a bespeak where you're drinking h2o and that might not even be able to work it'south way around somewhen. The bottom line in that location is it'south not going out, so information technology has to be something that has to come up out from to a higher place, so you have to get a Grand.I. doc in to go down with a scope, pull that thing out and remove it from above.

Interviewer: Is that how a toothpick would be removed every bit well?

Dr. Madsen: It is.

Interviewer: So you lot don't have to go operated on, it's actually but removed through the throat?

Dr. Madsen: It is.

Interviewer: All right.

Dr. Madsen: Yes, they're going to become downwards the esophagus and into the tum, find it, pull it out.

Interviewer: If I swallowed something and it's blocking stuff upwardly, what does that feel like then?

Dr. Madsen: All right. So if yous eat something, you can experience it. And a lot of people volition come in and . . . kind of the matter we encounter at that place more is people more after they swallow a piece of meat without chewing it completely, you lot just feel a fullness in your throat and a lot of times people can point to exactly where it is. They can feel information technology upper throat, their lower pharynx or kind of downwards most the stomach, and often times they cannot swallow annihilation. They will merely exist sitting there with a cup spitting out their saliva, as they cannot actually eat it. If they endeavor to it just comes correct back up.

Interviewer: What if it makes it to the stomach and it'southward blocking that?

Dr. Madsen: You lot're usually non going to accept a lot of signs at that place until it'south fairly progressed. And then I would expect if information technology were blocking the stomach, y'all might not feel it. You're probably going to feel some discomfort in in that location only probably after yous offset to swallow and if you've been eating a decent amount of food, you tin just feel like information technology's just not moving anywhere, just similar a rock in your stomach.

Interviewer: Would your body eventually throw up that food?

Dr. Madsen: Exactly. If yous go enough in there, information technology'due south just going to build up and somewhen it's just going to get full and it'southward but going to come right dorsum upwards.

Interviewer: So dominion of thumb, if you eat something, width, length, what do I look out for?

Dr. Madsen: So in terms of width and length, remember longer than about five" or wider than almost 2", and that's kind of just a general rule of pollex. So if information technology'southward something that's sharp that could potentially cause a perforation in the intestines, that'southward concerning as well. And certainly with these, if you're non sure what to exercise, err on the side of circumspection, come to the emergency section and then we can help make appropriate decisions and become our specialist involved equally well.

Interviewer: We're your daily dose of science, conversation and medicine. This is The Scope, Academy of Utah Health Sciences Radio.

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