Patient's Intentional Ingestion of Knives, Pens, Batteries: Tough Act to Swallow


Moss said that most patients who have endoscopic surgery are given "soft" or conscious sedation. Many of the patients who swallow objects need to be given general anesthesia because they are on psychiatric medications that could interfere with the ability to sedate them. The general anesthesia adds significant cost and means booking added time for an operating room.

For Some Intentional Ingestion Patients, Options Exist

Dr. H. Steven Moffic, a professor of Psychiatry at the Medical College of Wisconsin who has written or contributed to 500 publications and presentations relating to psychiatry, said there are treatment options for certain patients.

"As far as psychotherapy goes, probably cognitive-behavioral psychotherapy is the best because it can alter how one thinks about things negatively or inappropriately," said Moffic.

But Moffic said the difficulty in treating the person doing the ingestion is two-fold.

"Those who do it for attention or secondary gain might not want to get better," Moffic said. "[And] some of the underlying disorders are among the most difficult to treat, especially the personality traits or disorders of a borderline, sociopathic, or narcissistic nature."

The Prison Difference

Moffic has done extensive psychiatry work and research in prisons. For prisoners, the reasons behind ingesting objects can be different.

"Often, the reason is to hide what is swallowed and then to actually try to retrieve it when defecating, with the assumption that the object will not be altered," said Moffic.

"In prison, medical and psychiatric treatment is provided when this is done," said Moffic. "Most important is that there is not much other positive reinforcement for the behavior, as the inmate is, in fact, punished by being put into a segregation unit for a long period of time."

Moffic said that such a reprimand discourages repeat behavior in individuals and the prison population as a whole. Outside of prison, such discouragement generally is not conveyed.

But outside or inside, it can be a wearisome process for health care professionals.

"Our numbers are similar to those at Rhode Island Hospital," said Malone. "It isn't something we see often, but when it does happen, it can be frustrating. We're used to people wanting to get better, so it can take a toll on caregivers."

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