Concerns About Swallowing a Toothpick: What You Need to Know

Suspected ingestion?

Hello, doctor.
Two weeks ago, while helping a colleague with some items, I may have accidentally ingested something.
During that time, I was experiencing persistent discomfort in my head and have a habit of biting on a toothpick to relieve some of the tension, which might be causing tension headaches due to malocclusion.
I was biting on a toothpick while wearing a mask and went downstairs to help move items upstairs.
After making two trips, I returned to my room feeling very tired and out of breath, so I removed my mask to take deep breaths and rested for over half an hour.
It was only then that I suddenly remembered the toothpick.
Normally, I would place my toothpick in a designated spot after taking it out of my mouth, but this time I didn’t see it, and I didn’t feel any significant sensation of swallowing something or any sharp pain while moving items or catching my breath.
Later, I found a toothpick in one location, but I’m not sure if it was the one I was using that day.
What is the likelihood that I accidentally ingested the toothpick? On March 18, I visited a doctor who took X-rays of my chest and abdomen and said that nothing was clearly visible.
I was advised to monitor for two days to see if I experienced any pain, and if I did, to go to the emergency room.
Now, nearly half a month later, I have not experienced any significant discomfort, but I am very anxious about the possibility of having actually swallowed it.
Doctor, what is the likelihood that I ingested it? Do I need to undergo an endoscopy, or is there a more precise method to determine whether that toothpick is in my body? I feel anxious every day and it’s driving me almost to madness.
Thank you, doctor.

Jiao lü, 30~39 year old female. Ask Date: 2022/04/13

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
A 32-year-old male is concerned about accidentally swallowing a toothpick.
While some toothpicks may pass through the digestive tract without issue, a small portion can cause perforation and inflammation, such as mediastinitis or purulent peritonitis.
Symptoms typically arise in these cases.
It is advised to monitor for any signs of sore throat, chest pain, abdominal pain, or fever.
If any symptoms occur, seek medical attention promptly.
Please use toothpicks with caution.

Wishing you safety and good health.

Sincerely,
Dr.
Ming-Hui Lin,
Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2022/04/13

More Info

Swallowing a toothpick can be a concerning situation, and it's understandable that you're feeling anxious about it. Let's break down the situation and what you should consider moving forward.

First, it's important to understand that swallowing a toothpick can lead to various complications, depending on where it ends up in the digestive system. If a toothpick is swallowed, it can potentially cause injury to the esophagus, stomach, or intestines. The sharp edges of a toothpick can puncture or lacerate these organs, leading to serious health issues, including internal bleeding or infection.

In your case, you mentioned that you did not experience any immediate discomfort or pain after the incident. This is a positive sign, as many complications from swallowing foreign objects typically present symptoms relatively quickly. Common symptoms to watch for include:
1. Abdominal Pain: This could indicate that the toothpick has caused damage to the gastrointestinal tract.

2. Nausea or Vomiting: If you feel nauseous or vomit, it could be a sign that something is wrong.

3. Difficulty Swallowing: If you experience pain or difficulty when swallowing, it may suggest that the toothpick is lodged somewhere in the esophagus.

4. Fever: A fever could indicate an infection resulting from a perforation.

Since you had an X-ray done shortly after the incident and the doctor did not find any evidence of a foreign object, this is reassuring. However, X-rays may not always detect small or thin objects like toothpicks, especially if they are made of wood, which does not show up well on X-rays.

Given that you are still feeling anxious about the possibility of having swallowed the toothpick, here are some steps you can take:
1. Monitor Symptoms: Continue to monitor your body for any of the symptoms mentioned above. If you start to experience any concerning symptoms, seek medical attention immediately.

2. Consult Your Doctor: If your anxiety persists, it may be worth discussing your concerns with your healthcare provider. They may recommend further imaging studies, such as a CT scan, which can provide a more detailed view of your gastrointestinal tract and may be more effective in detecting foreign objects.

3. Consider an Endoscopy: If there is still a high level of concern and symptoms develop, your doctor might suggest an endoscopy. This procedure allows a doctor to look directly into your esophagus and stomach using a flexible tube with a camera, which can help determine if there is any foreign object present.

4. Manage Anxiety: It's important to address your anxiety about this situation. Consider speaking with a mental health professional if your worries are affecting your daily life. Techniques such as mindfulness, relaxation exercises, or cognitive-behavioral therapy can be beneficial in managing anxiety.

In conclusion, while the risk of complications from swallowing a toothpick exists, the absence of symptoms and the results of your X-ray are encouraging. Continue to monitor your health, consult with your doctor for further evaluation if needed, and take steps to manage your anxiety. Remember, it's always better to err on the side of caution when it comes to your health.

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