# Swallowed or lodged foreign body (digestive tract) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD36 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pediatric Foreign Body Ingestion - StatPearls - NCBI Bookshelf (NBK430915) - https://www.ncbi.nlm.nih.gov/books/NBK430915/ - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Swallowed or lodged foreign body (digestive tract) - disease-level clinical article (gi-foreign-body-clinical.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text SWALLOWED OR LODGED FOREIGN BODY (DIGESTIVE TRACT) Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD36 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pediatric Foreign Body Ingestion - StatPearls - NCBI Bookshelf (NBK430915) - https://www.ncbi.nlm.nih.gov/books/NBK430915/ Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care, Swallowed or lodged foreign body (digestive tract) - disease-level clinical article (gi-foreign-body-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Many children have no symptoms, or only mild ones like a sore throat, chest tightness, or a sense of something stuck [chest pain · sore throat] - Trouble swallowing, painful swallowing, food refusal, or being unable to manage saliva points to an impacted object [difficulty swallowing · painful swallowing] - Adults with an impacted object typically report a globus sensation, painful swallowing, and chest pain [chest pain · painful swallowing] SIGNS - what you find (4) - Drooling with an inability to swallow liquids strongly points to esophageal obstruction requiring urgent endoscopy [drooling] - A crackling or popping sensation felt in the neck (crepitus) indicates air within the subcutaneous tissue [crepitus] - Guarding and rebound tenderness on the abdomen raise concern for peritonitis [guarding · rebound tenderness] - Shock, breathlessness, or respiratory distress can point to a perforation from the foreign body [breathlessness · foreign body · shock] TESTS (6) - Plain x-ray is the first-line imaging test for a suspected swallowed object - About 83% of swallowed foreign bodies show up on x-ray because they are radiopaque - Overall only about a third of ingested foreign bodies are detected on plain x-ray - A full work-up includes frontal and lateral neck and chest films, plus an abdominal film - For suspected button-battery ingestion, x-ray all children under 12, and image older patients only if the battery exceeds 12 mm across - CT imaging should not delay emergency endoscopy for a suspected acute esophageal obstruction IF NOT THIS - what else fits (5) - Esophagitis is a differential for suspected foreign body ingestion - GERD is also on the differential for foreign body ingestion - Acute coronary syndrome in adults is on the differential for chest discomfort from a possible impaction - Pyloric stenosis is also on the differential for foreign body ingestion - Peritonsillar or retropharyngeal abscess is on the differential for foreign body ingestion Source StatPearls "Gastrointestinal Foreign Body" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult Covers swallowed objects (coins, fish bones, food bolus) and rectal foreign bodies; most need endoscopic or surgical removal. GP recognises danger signs (button batteries, sharp objects, complete obstruction) for same-day referral, and can advise watchful waiting for a small blunt object that has already passed the esophagus. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Covers swallowed objects (coins, fish bones, food bolus) and rectal foreign bodies; most need endoscopic or surgical removal. GP recognises danger signs (button batteries, sharp objects, complete obstruction) for same-day referral, and can advise watchful waiting for a small blunt object that has already passed the esophagus. Caution No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - There is a strict 2-hour window for esophageal button battery removal, due to rapid mucosal caustic burn and perforation risk. RED FLAG - Multiple magnets or co-ingested metal are a high danger sign (bowel loop attraction leading to necrosis, fistulization, and bowel perforation). RED FLAG - There is a strict 6-hour removal window for sharp objects lodged in the esophagus, to avoid mediastinitis and esophageal perforation. RED FLAG - Drooling or inability to swallow saliva (complete esophageal obstruction), or fever with chest or abdominal pain suggesting perforation. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)