Patient education: Chemical ingestion in adults (The Basics)

What is a chemical ingestion? — 

This means swallowing a harmful, "caustic" chemical. Caustic chemicals are very strong and can damage things they touch. They can be a liquid, powder, spray, or solid. These chemicals can be found in many types of products. Examples include cleaning products, pesticides, and products used to straighten hair.

Different chemicals can cause different injuries to the mouth, throat, stomach, or lungs. Some cause only mild or short-term symptoms. Others can cause severe damage, including blisters and scarring. How mild or serious an injury is depends on:

●The type of chemical

●If the chemical is more solid or liquid

●How much is swallowed

●How long the chemicals are in contact with the mouth, throat, or other tissues

What are the symptoms of a chemical ingestion? — 

It depends on what was swallowed and how much. In many cases, symptoms start right away after swallowing the chemical. But in some cases, symptoms can get worse over time.

Symptoms can include:

●Redness or irritation around the mouth

●Swelling of the lips or tongue

●Drooling

●Pain, especially when trying to swallow

●Vomiting, with or without blood

●Abdominal pain or distension

In some cases, chemical ingestion can also cause problems with breathing. This can happen if a strong caustic chemical burns the airway. Symptoms of breathing problems can include:

●Trouble breathing

●Cough

●Wheezing or high-pitched, noisy breathing (called "stridor")

●Hoarseness

Swallowing a chemical can also cause long-term problems. Examples include:

●Gastrointestinal bleeding – This is bleeding from the esophagus, stomach, or intestines (figure 1).

●Fistula – This is an abnormal connection between tissues like the trachea (windpipe) and lungs.

●Strictures – This is narrowing of the esophagus. It can lead to problems swallowing.

●Cancer of the esophagus

Will I need tests? — 

Yes. The doctor will do an exam, learn about your symptoms, and ask questions about what you swallowed. They will also order tests. The tests can check for specific substances in your body or look for problems the ingestion might cause.

You might need:

●Blood tests

●Urine tests

●Chest X-ray, CT scan, or other imaging tests – These create pictures of the inside of the body.

●Upper endoscopy to look at the lining of the esophagus, stomach, and upper part of the small intestine

●Electrocardiogram ("ECG") – This measures the electrical activity in the heart.

●Bronchoscopy – This looks at the back of the throat and the airway.

How is a chemical ingestion treated? — 

Treatment depends on your symptoms, what chemical you swallowed, and how much.

Treatment might include:

●A breathing tube or oxygen, if you are having trouble breathing

●Fluids given through a thin tube that goes into a vein, called an "IV"

●Pain medicine

●Medicine to treat nausea or vomiting

●Not eating or following a liquid diet, if there is damage to your mouth, throat, or esophagus

Depending on the injury, you might need surgery or might need to stay in the hospital for a time as you heal.

How can I help prevent a chemical ingestion? — 

Steps to prevent accidental ingestions include:

●Store all harmful substances where children and pets cannot get to them. Examples include alcohol, medicines, cleaning products, and insect or rodent poisons. If you have to store these within reach of children, put them in cabinets or drawers with child safety locks.

●Keep harmful substances in their original containers. This lowers the risk of someone mistaking them for something else. Close all containers fully, and store them safely.

●Get rid of chemicals when you no longer need them.

In some cases, a caustic chemical ingestion is an attempt at self-harm. If you are struggling to cope, tell your doctor or nurse right away. They can get you help.

More on this topic

Patient education: Chemical skin burn (The Basics)
Patient education: Upper endoscopy (The Basics)
Patient education: Diagnostic bronchoscopy (The Basics)

Patient education: Upper endoscopy (Beyond the Basics)
Patient education: Flexible bronchoscopy (Beyond the Basics)