10,11įurthermore, there is a lack of medical literature available discussing extensive evaluation and management of patients who continuously ingest foreign body objects from an in-depth psychiatric perspective in relation to psychiatric disorders. In a few instances, surgery may be necessary. It is believed that 80%–90% of ingested foreign objects spontaneously pass through the gastrointestinal tract however, 10%–20% require endoscopic intervention. The removal of foreign bodies ultimately falls on gastroenterologists. 9Ī lot of consideration is required from various specialties that partake in the management of a patient with IFBI, including emergency, psychiatry, surgery, nursing, and other hospital staff. 8 The average cost of a single patient with IFBI per hospital visit is $6,616 in the US and $2,305 in Canada, with an average inpatient admission duration of stay of 5.66 days. 8 Of these patients, 79% were psychiatrically diagnosed, resulting in a total cost of over $2 million. A retrospective case study of 33 patients was conducted in which 305 cases of IFBI were identified.

IFBI can be challenging to treat because these patients can place a considerable burden on hospital resources and time. 6 This association of personality disorder with repeated ingestion of foreign objects and self-mutilation was first described in 1950 by Carp. 4 Patients with BPD commonly exhibit self-harming behavior, with 80% of patients acting upon eventual self-harm and over two-thirds making at least one suicide attempt. 5 For a definitive diagnosis of BPD, the DSM-5 requires at least 5 of the following criteria to be present: unstable interpersonal relationships, attempts to avoid abandonment, recurrent suicidal or self-destructive behavior, reckless impulsivity, unstable mood or affect, persistent unstable self-image, chronic feelings of emptiness, struggling with anger management, or transient paranoia or dissociative symptoms. Research has shown an association of IFBI with a diagnosis of borderline personality disorder (BPD), 4 which carries an estimated lifetime prevalence of 1% in the general population and 22% in the inpatient psychiatric population. A study by Palta et al 3 involving 262 cases of foreign body ingestions found 92% of cases were intentional, 85% were psychiatric patients, and 84% of cases were seen in individuals who had a previous history of ingestion. 1 The presence of foreign bodies found in patients’ intestines was first reported by Baudamont in 1779, 2 being seen in psychiatric patients and in those with no psychiatric history. Objects most commonly ingested include, but are not limited to, pens, nuts and screws, toothbrushes, eating utensils, razor blades, and various other metal objects. Intentional foreign body ingestion (IFBI) is rarely seen among the psychiatric population and is a form of self-destructive behavior.

Pica disorder length to diagnosis