Children are curious by nature. They pick up small objects, play with them and sometimes end up putting them in their mouth. Coins, beads, toy parts, batteries, magnets and even small pieces of plastic or metal can accidentally be swallowed.

In many cases, a small object passes through the digestive system on its own. But sometimes it gets stuck in the food pipe or can cause serious injury. This is when endoscopy becomes an important treatment option.

If your child has swallowed a foreign object, the most important thing is to get the child assessed promptly. Waiting for symptoms is not always a good idea, particularly when the object is a button battery, magnet or sharp object.

What happens when a child swallows a foreign body?

Once swallowed, the object usually travels through the food pipe into the stomach and then the intestine. Whether it needs to be removed depends on several factors, including the type and size of the object and where it is located.

A coin may sometimes pass naturally. A button battery is a completely different situation because it can cause serious burns to the food pipe. Similarly, multiple magnets can attract each other inside the intestine and potentially cause perforation or obstruction.

Sharp objects such as needles, pins or sharp pieces of bone can also cause injury and may need to be removed.

How is the object removed by endoscopy?

Endoscopy is a minimally invasive procedure in which a thin flexible camera is passed through the mouth into the food pipe and stomach under sedation by an expert pediatric anesthetist after atleast 6 hours of fasting. These kids often require short admission and in some cases day care procedure can also be done.

If the foreign body is seen, special instruments like roth net, forcepts etc can be passed through the endoscope to hold it. Depending on the object, the doctor may use forceps, a retrieval net, a snare or other specialised instruments.

The object is then carefully removed through the mouth. If the object is large/sharp or there is risk of slipping while withdrawing the scope, in some cases, intubation is done before the procedure.

When is foreign body removal an emergency?

Some swallowed objects require urgent attention like button battery, magnets, sharps etc.

Button batteries are particularly dangerous and should be treated as an emergency. They can start damaging the food pipe even when the child initially looks well. Magnets can also be dangerous, especially when more than one magnet has been swallowed. Sharp objects may cause bleeding, perforation or other injury. A foreign body stuck in the food pipe needs immediate removal.

The image below shows a button battery ingested by a 3 year old child.

Does every child need endoscopy?

No.

Not every swallowed object needs to be removed. Sometimes the safest option is simply to observe the child and allow the object to pass naturally. The decision depends on the object, its location, the child’s age and symptoms and the possibility of complications.

An X-ray may be done first because many commonly swallowed objects, such as coins and batteries, can be seen on an X-ray. Depending on the location in gut, decision to proceed for endoscopy is taken.

Why experience in paediatric endoscopy matters

Endoscopy in a child is different from routine endoscopy in an adult. The size of the child, the type and location of the foreign body and the need for appropriate paediatric anaesthesia all have to be considered. The aim is not simply to remove the object. It is to remove it safely while minimising injury to the food pipe and stomach.

This is why parents should ideally consult a paediatric gastroenterologist or a centre experienced in paediatric endoscopy when a child has swallowed a potentially dangerous foreign body.

Where can parents seek consultation?

Parents looking for a child gastroenterologist in Vasant Kunj can consult Dr. Vipul Gautam for paediatric gastrointestinal problems and endoscopic procedures.

Families searching for the best child gastro doctor in Vasant Kunj, best child gastro doctor in Mehrauli, best child gastroenterologist in RK Puram, best child gastro doctor in Chhatarpur, best child gastroenterologist in Vasant Vihar, best child gastro doctor in Mahipalpur or best child gastroenterologist near Nangal Dewat may consider a specialist with experience in paediatric gastroenterology and therapeutic endoscopy.

For parents, proximity is often important during an emergency. Vasant Kunj is accessible from several parts of South Delhi, including Mehrauli, Chhatarpur, Vasant Vihar, RK Puram, Mahipalpur and Nangal Dewat.

What should parents do if they suspect ingestion?

If you have seen your child swallow a foreign object, try to identify what the object was and when it was swallowed.

Do not try to make the child vomit.

Do not give food or drink as a way of trying to push the object down especially banana. Many parents give child banana after foreign body ingestion which should be avoided. As anesthetist need 6 hours of fasting before giving sedation and it unnecessarily delays the procedure.

Seek medical advice promptly, particularly if it was a button battery, magnet, sharp object or an object that may be stuck in the food pipe. Many children do not have any symptoms after accidental ingestion of dangerous objects like button battery or magnets.

The good news about endoscopic removal

The majority of foreign bodies that require removal can be managed endoscopically. This means that the child can often avoid an open surgical procedure.

The procedure allows the doctor to see the foreign body directly, remove it using specialised instruments and examine the surrounding area for any injury. In case the object goes beyond the limit of upper GI endoscope, observation and inhospital stay is recommended.

If your child has swallowed a foreign object, don’t wait for symptoms to become severe. Get the child assessed by a paediatric gastroenterologist, particularly when the swallowed object is a battery, magnet or sharp object.