If a LEGO is Swallowed, How Long Does it Take to be Pooped Out?

This is one of those published research papers I had to wonder if it was for real or not... but it appears to be genuine in spite of the jocular tone of the article. Published in the Journal of Pediatrics and Child Health , researchers swallowed small LEGO pieces and then monitored bowel movements to determine how long it took before it got pooped out. The general point of the study being that children often swallow toy objects and as long as it doesn't get stuck in the throat (and lack…

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Drinking Honey Reduces Throat Damage after Swallowing Button Battery

Button batteries swallowed by children cause significant damage to the lining of the throat and esophagus and has the potential to cause significant swallowing difficulties both in the short-term due to mucosal injury as well as long-term issues from scarring. Serious damage can occur within 2 hours of battery ingestion and deaths have also occurred due to button battery ingestion. As such, any intervention that can be done to minimize mucosal damage from the moment of swallow until the butto…

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Swallowed Coin Removal without Sedation Using a Foley in a Young Child

A blog subscriber recently informed me about a video showing a coin being removed blindly from a young child using only a foley catheter without any sedation. Watch video  above... This blind removal technique basically involves passing a small foley catheter through the mouth and PAST where the coin is located within the esophagus, typically behind the voicebox. The foley catheter balloon which would then be located past where the coin would be, is then inflated with a syringe. After ballo…

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Metal Detector Instead of X-rays for Swallowed Coins and Other Metallic Objects

Handheld Metal Detector Due to a recent rash of consults of patients swallowing coins and other foreign bodies mainly in kids but adults too, it occurred to me that a handheld metal detector similar to one that is used in airport security screening can quickly and easily determine whether a metal object is present within the body as well as where. This quick screening can serve three purposes... 1) X-rays can be avoided along with its radiation exposure. Typically, a neck, chest, and …

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The Artificial Larynx

Image from Protip Medical We have had artificial lungs, artificial hearts, artificial kidneys... but now we also have an artificial larynx. Published in the New England Journal of Medicine in Jan 2017, French researchers described a patient who required the entire voicebox removed (laryngectomy) due to cancer and than implanted with a totally artificial larynx in 2015. This patient is actually the second patient who has undergone artificial laryngeal implantation. The first occurred in 2…

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The 12 Cranial Nerves set to the 12 Days of Christmas

A twitter follower of mine  @dysphagiacafe sent me this video link describing the 12 cranial nerves set to the 12 days of Christmas. Check it out!

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Botox Injection Severe Side Effects Treatment

Side effects from botox injections are not uncommon and even expected to some degree in the region where the injection was performed. For example, when botox is injected into the voicebox for spasmodic dysphonia , normal and expected side effects include hoarseness and dysphagia . However, in very rare instances, more severe side effects may occur that may even appear to be life-threathening including stridor , shortness of breath, profound difficulty swallowing , etc. Botox overdose so …

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How Long Do Swallowing and Voice Problems Last After C-Spine Surgery ACDF?

I often see patients for swallowing and/or voice difficulties after cervical spine surgery (ACDF) . In the vast majority of cases, reassurance that such "side effects" are not uncommon is the only thing I need to provide after a complete exam. After all, both the voice box and swallowing tube are manipulated and pushed over to one side in order to perform cervical spine surgery from an anterior approach. Check out the video below that illustrates how this happens. Beyond reas…

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First Implantation of Human Artificial Larynx Announced!

Image taken from DNA ProTip SAS and Strasbourg University Hospitals announced that a fully artificial larynx was implanted into a human for the first time. Made entirely of titanium, the surgery was performed in two stages into a man with throat cancer that required his entire voicebox to be removed (laryngectomy). Stage 1: In June 2012, the larynx was removed and a titanium tracheal ring was implanted in its place. Stage 2: In November 2012, a removable valve-based device was inse…

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Dangerous Tongue Patch Procedure for Weight Loss

Image from Wikipedia There is a clinic in Beverly Hills who has been offering a risky "tongue patch" procedure in order to achieve weight loss of about 30 pounds in a single month. Although this clinic is currently the only one providing this "service" in the United States, it has been performed in Venezuela for quite some time. In essence, a mesh made of marlex typically used for hernia repair is surgically sutured to the back area of the tongue and left in place for…

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Do Nosebleeds Cause Stool Blood Tests to Become Positive?

As a general rule, an ordinary nosebleed will not cause a screening stool blood test  (hemoccult or guaiac) to come back positive. However, if the nosebleed is bad enough to consider going to the emergency room... and you are swallowing a lot of it... only than will it be likely that such stool tests will come back positive for blood. To be precise, such stool tests turn positive only if there's at least 2+ teaspoons of blood leaking into the digestive system everyday (or swallowed…

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I Am Taking a Reflux Medication & My Symptoms are Not Improving!

On an almost daily basis, I get an email from somebody with the same exact question or near-variation: "Dear Dr. Chang,  I have been taking a [ insert reflux medication ] for [ insert number ] weeks and I see no improvement in my [ insert symptom ]. What should I do?" The reflux medication typically mentioned include nexium, dexilant, prilosec, prevacid, protonix, or some other proton pump inhibitor . The most common symptoms typically mentioned include: • Globus • …

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How Much Tongue Can Be Removed Without Affecting Function?

Unfortunately, whether through trauma or cancer concerns, parts of the tongue may be removed. When a part of the tongue is removed, the principal concern patients have is whether speech and swallow will be affected. The answer to this question depends on 3 main factors. • What orientation is the tongue removed? • How much is removed? • Will nerve function be preserved? The nerve is what makes the tongue move (specifically cranial nerve 12  called the hypoglossal nerve) Regar…

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Bi-Lobed Zenker's Diverticulum

In the not so distant past, I saw a patient who suffered from a bi-lobed Zenker's Diverticulum. Zenker's diverticulum for those who don't know is the abnormal development of a pouch in the throat causing symptoms of phlegm in the throat , food regurgitation, swallowing difficulties , and aspiration. Most Zenker's Diverticulum is composed of a single central pouch. However, there are more rare varieties such as this bi-lobed pouch seen on barium swallow. However, at tim…

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Lithium Disc Battery Danger for Kids (and Hot Dogs)

In the last 10 years, 13 deaths related to swallowed batteries have been reported, 12 of which were due to disc batteries (20 millimeter lithium cells). The danger is that when a disc battery is inserted into a nose (for example), a localized electric current is created between the positive and negative poles of the battery within the nose. This electric current basically "electrocutes" the lining inside the nose leading to tissue damage and ultimately necrosis (tissue death) wi…

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Saliva Test for Laryngopharyngeal Reflux (LPR)

Various groups have been developing a fast, cheap, non-invasive saliva swab test to determine whether laryngopharyngeal reflux (LPR) is present or not. LPR may cause symptoms of: Hoarseness Chronic (ongoing) cough Frequent throat clearing Constant mucus or phelgm in the throat Dry or sandpaper like sensation in the throat Pain or burning sensation in the throat Feeling of a lump in the throat (globus pharyngeus) Problems swallowing Bad/bitter taste in the mouth (especially in m…

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Video on Zenker's Diverticulum Surgery (Endoscopic Staple Diverticulostomy)

Our office has produced a new video describing Endoscopic Staple Diverticulostomy to treat Zenker's Diverticulum. We have the unusual honor of having treated patients throughout the United States for this rare condition. Patients we have successfully treated have come from as far away as Oregon, New York, Florida, Pennsylvania, Louisiana, Arizona, etc. For more information, please visit us here .

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How Does Cervical Spine Surgery Potentially Cause Voice and Swallow Problems? [video]

It is not unusual for an ENT surgeon to see patients with swallowing and voice difficulties after cervical spine surgery. In particular, the ACDF surgery (Anterior Cervical Discectomy and Fusion). The key to understanding these issues is to first understand the anatomy involved. The cervical spine is located in the back of the neck. In front of this spine is the esophagus (swallowing tube) and voicebox . As such, when a spine surgeon goes through the FRONT of the neck in order to per…

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New Video on Esophageal Manometry and 24 Hour Multi-Channel pH and Impedance Testing

Our office has created a new video describing what a patient goes through when they undergo esophageal manometry as well as 24 hour multi-channel pH and impedance testing. This test is often ordered when a patient is suspected to be suffering from reflux , whether acid or non-acid , or is possibly suffering from abnormal muscle activity of the esophagus. Symptoms that a patient may experience that may lead to such testing include: - phlegmy throat - lump sensation in the throat - chr…

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New Video of Phlegmy Throat

In this video , the patient suffered from a severe phlegmy throat after suffering from a stroke. His secretions did not pass down to his stomach, but rather collected in his throat causing constant throat-clearing and coughing up clear phlegm. As you can see in the video, there is a tremendous amount of mucus pooling present. Treatment was geared toward improving his swallowing function so that his secretions would not collect in his throat. If you are not sure what normal is supposed…

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