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Swallowed a piece of plastic. CAT scan showed clear. Feeling pressure in throat. What to do?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2559 Questions

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Posted on Mon, 24 Dec 2012 in Ear, Nose and Throat Problems
Question: Yes, I swallowed a small round piece of plastic a month ago, maybe about 1/4 inch diameter. I went to ER after a week;catscan showed nothing. I went to an ENT & he scoped my throat 2 x, & can't find anything. He said go see a gastroenterologist. I went to my primary care & she said take Prilosec because it's heartburn & she didn't see anything. They both think I am making it up. I know I swallowed it, it moves around in my throat, front or side or back. Feels like a hard edge, like I swallowed an XXXXXXX peel. It won't go down no matter what sticky or smooth foods I eat. Should I ask my husband to do a heimlich or should I try to regurgitate somehow or lie over edge of bed with my head down & let gravity do it's work? Or just work on coughing it ou?Or is there an expert you can refer me to? I go to doctors preferably in Bergen County NJ & my insurance is Blue cross blue shield Direct Access.The plastic was clear, and very thin. I found another piece just like it; it is 1/2" in diameter (round circle). I can eat, drink, sleep ok. When I "swallow" I can feel it; now I feel slight pressure towards the right side of my throat. When I wake up in the AM I don't feel it at first, only later. My voice starts to go slightly hoarse later in the day.
doctor
Answered by Dr. Sumit Bhatti 6 hours later
Hi,

Thank you for your query.

1. You should see another ENT Specialist. Get your throat and larynx examined by a video-laryngoscope. This would also help rule out any associated conditions. Ask for a chest auscultation, X-ray and barium swallow.

2. It is highly unlikely that a rounded foreign body such as a round plastic piece will be held up somewhere in the throat. What is more important than the size is the edge. If it is very thin and sharp, it may lodge in the lining of the throat or gut. because of it's clear transparent nature and thin size, such a foreign body would be r=extremely difficult to spot, especially is it is seen 'edge-on' during endoscopy. Multiple passes and indirect evidence such as lacerations, bleeding or a foreign body reaction may help find it. It is also unlikely to be in the airway, as the spasms and coughing would be very violent. As such, plastic does not show easily up on X-rays or CT Scans as it is not radio-opaque. Plastic is inert and hence unlikely to cause additional reactions in the body. The cricopharynx (upper opening of the food pipe / esophagus) is the narrowest part of the gut. Once the food has passed through this area, it passes through the entire gut in a couple of days. One month is too long, even for an injury that it may have caused to heal.

3. Foreign bodies, however are notorious for bizarre presentations. It is better to go through this simple examinations to remove all doubt. These conditions are worsened by acid reflux and stress. A flexible endoscopy may be suggested by your physician, concentrating around the region of discomfort on the right side.

4. Kindly let me know the results of your tests. This will help in suggesting further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 8 hours later
I am very allergic to shrimp/shellfish (hospitalized with severe itching rash inside my stomach & all over my body;and I found out that iodine is in the barium swallow. If the other methods don't work, & I can't have the barium swallow, then what?
doctor
Answered by Dr. Sumit Bhatti 4 hours later
Hi,

Thank you for writing back.

1. The radio opaque XXXXXXX used in a barium swallow study is barium sulfate.

2. The chemical formula for barium sulfate is BaSO4. It is composed of barium, sulfur and oxygen.

3. Barium sulfate does not contain iodine. It is an alternative to iodine based radio-opaque contrast agents.

4. Sea food allergy is not strongly associated with iodine allergy. Do you use non-iodinated salt?

4. Allergy to barium sulfate is a possibility, but it is rare as the barium is not absorbed by the body.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 4 hours later
I went to another ENT; he did the scope & did not see any plastic. He said
Take Prilosec; take Maalox 2x a day & gargle with it. I will go back in a week.
He said the only other option is then surgery but did not go into specifics.
If you we're me what would you do? I still feel something on the left side
Of my neck. He did not say he saw any lacerations or irritation. I don't get why he is
Prescribing these OTC drugs. I have never had any heartburn, reflux. If I've felt something from my stomach it's never been localized or hurting or moving around from place to place in my throat. Is he giving me this as a placebo?
doctor
Answered by Dr. Sumit Bhatti 11 hours later
Hi,

Thank you for writing back.

1. It is not possible for the foreign body to move from the right to the left or around in the throat without being swallowed. It may, however, be partially lodged in the throat.

2. The medicines prescribed are for reducing any acid reflux, which will worsen the symptoms.

3. If your symptoms persist after a week, you may require examination under general anesthesia. This is what your ENT Specialist may have been refeering to as 'surgery'.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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