In the United States, coins are the most common objects ingested by children, particularly those under the age of 5, according to a July 2005 report in “American Family Physician.” Most often, these coins pass through the digestive tract without causing harm. But sometimes a coin can get stuck and cause problems, so if your child swallows a coin -- even if he shows no signs of distress -- his pediatrician should be notified.
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Down the Esophagus
When a coin is swallowed, it travels down the esophagus en route to the stomach. Although most swallowed coins continue through the digestive tract and get passed in the stool, some coins get stuck along the way. Because of this risk, clinical practice guidelines from the American Society of Gastrointestinal Endoscopy outline that coins within the esophagus be observed, usually via x-ray, if no symptoms are present, and removed within 24 hours if the coin does not pass into the stomach. If symptoms of drooling, chest pain, high-pitched wheezing or difficulty breathing persists, the coin needs to be removed immediately.
Into the Stomach and Intestines
Swallowed coins that move past the esophagus travel through the digestive system and usually get passed within a few to several days. Healthy children are at low risk of a coin getting stuck, but children with prior intestinal surgeries or conditions that result in narrowing of the intestines have a greater risk of this complication. In the uncommon situation where the coin lodges in the stomach or intestines, symptoms such as abdominal pain, fever, vomiting, or blood in the stool signal the need for immediate removal.
Excretion or Removal
According to an October 2014 report in “World Journal of Gastrointestinal Endoscopy,” 80 to 90 percent of ingested objects pass through the intestinal tract without medical intervention. To ensure your child has passed the coin, his doctor may want you to search for the coin in your child’s stool. However this is not a highly effective strategy. If your doctor needs to determine if the coin has passed, imaging tests can also be performed. If the coin is stuck, the doctor will need to remove it.
If your child has swallowed a coin, try to stay calm and keep your child calm. Let your pediatrician know, and seek advice on next steps. Monitor your child’s symptoms, and seek immediate medical attention if he has chest pain, difficulty breathing, abdominal pain, vomiting or blood in the stool. Do not try to make your child vomit or provide a laxative, as these steps can be dangerous and ineffective. Also see a doctor right away if potentially dangerous items have been swallowed, such as sharp objects, batteries or magnets.
Reviewed by Kay Peck, MPH RD
- American Family Physician: Foreign Body Ingestion in Children
- Pediatrics in Review: Foreign Body Ingestion and Aspiration
- Gastrointestinal Endoscopy: Management of Ingested Foreign Bodies and Food Impactions
- World Journal of Gastrointestinal Endoscopy: Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: A Review