Errol Korn, MD, guest author of Nuts & Bolts, is a Gastroenterologist in private practice in Chula Vista, CA. Robert L. Martin, PhD, who usually writes this column, can be reached at 7750 University Avenue, La Mesa, CA 91941.
When I was being fitted with hearing aids, my audiologist, Dr. Robert Martin, explained to me the “do's & don'ts” of proper hearing aid use, including that I should keep my hearing aid batteries away from babies. I told him he was talking to a gastroenterologist who had recently removed a hearing aid battery from an elderly adult's esophagus.
Figure. Errol Korn...Image Tools
The fact is, people of any age can and do accidentally swallow batteries. Hearing aid batteries are small and can be confused with a piece of candy or a pill. So, all of us should be careful with them.
In my practice we often remove objects from the gastrointestinal (GI) tract. A wide variety of household items can be accidentally swallowed. Most pass naturally, but there are cases when they do not.
The most useful suggestion for avoiding accidental battery ingestion is to keep batteries up, out of reach, and out of sight—especially of children. But accidents do happen. Fortunately, it is easier than one might think for doctors like myself to remove foreign objects from the GI tract, thanks to marked improvements in medical equipment. Here is how it is done.
After the patient has been sedated, the physician uses a fiber-optic endoscope to view the inside of the tract. The endoscope is a soft, flexible tube with fiber-optic microfilaments that provide excellent light and visibility. The endoscope has a channel through which the doctor can insert various instruments to remove foreign objects.
If a battery gets stuck it can cause a serious problem if it is not removed quickly. The battery material can leak, causing inflammation or even a perforation in the digestive tract. The sooner appropriate treatment is given the better. The patient's physician should promptly refer him or her to a gastroenterologist, who will locate the battery and remove it.
If one of your hearing healthcare patients calls you to report a case of battery ingestion, please be careful what you tell them. You do not want patients trying to fix this problem at home. It is better to seek professional help. Home remedies like the use of laxatives and waiting for the battery to pass may make the problem worse. If a battery is accidentally swallowed, tell the patient to make an appointment with his or her physicians. The patient will be sent for an x-ray, where the battery is easily seen.
We sometime refer to the GI tract as a “tube,” so people may get the idea that the esophagus, stomach, and intestinal tract are smooth tubes like plastic water pipes. In fact, the anatomy of the GI tract is complex, and pockets and flaps are common. The large intestine, for example, may have many nooks and crannies where a battery can become lodged.
COMMON SENSE SUGGESTIONS
Here are some practical ideas for reducing the risk of battery ingestion.
1. Store hearing aid batteries out of reach of all children. Never let a child play with a hearing aid or a battery. Children have a habit of putting things in their mouth.
2. Pediatric hearing aids have battery locks on the instrument. Be sure these are activated when the child wears the hearing aids.
3. When you handle batteries, work over a terry-cloth towel. If you drop a battery onto the towel, it's easy to see and retrieve. If you drop it onto a hard table surface, the battery is likely to end up on the floor. That can force you to waste time and energy looking for it. Even worse, if you don't find it, the “lost” battery is a hazard. You or a patient can step on it and fall, or a child may find it and eat it.
4. Never put batteries or hearing aids on a table or nightstand where you put food or drinks. If people are distracted and not paying close attention to what they are doing, they can easily pick up a battery thinking it's a pill or a piece of candy and swallow it.
5. If you store batteries in your purse, keep them separate from any pills you carry.
6. Finally, never put a battery in your mouth—for any reason!
The old days of “cutting people open” are long gone. Now, using fiber-optic instruments, gastroenterologists routinely remove foreign objects without need for major surgery. The best advice you can give someone who accidentally swallows a battery is, “Go to your doctor.”
© 2009 Lippincott Williams & Wilkins, Inc.