Dawaa Reference

Clinical reference

Swallowed or lodged foreign body (digestive tract)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 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 against2 documents
  • 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)

Verified date2026-08

Presentation reference

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

SourceStatPearls "Gastrointestinal Foreign Body" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

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

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose 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.

Cautions
  • 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.