Toilet Paper Ingestion: Emergency Risks & Immediate Actions
Ingesting toilet paper is a medical emergency. It can form a bezoar causing gastric or intestinal obstruction, perforation, ischemia, or sepsis.
Immediate Steps
- Call 911 / local emergency number or go to the nearest ED immediately.
- Do NOT induce vomiting (aspiration risk; paper expands when wet).
- Do NOT eat/drink until evaluated (may need surgery).
- Bring packaging if possible (quantity, additives).
Why It's Dangerous
- Toilet paper absorbs gastric fluid → expands → large, cohesive mass.
- Not digestible; no enzymatic breakdown.
- Can lodge at pylorus, ileocecal valve, or anastomoses.
- Associated with pica (iron deficiency, pregnancy, autism, psychiatric conditions).
Hospital Evaluation
- Abdominal X-ray / CT (contrast if no perforation suspected).
- Labs: CBC, electrolytes, lactate, coagulation, iron studies.
- Management: Endoscopic retrieval (if gastric), enteroscopy, or laparotomy/laparoscopy for obstruction/perforation.
- Psychiatric/pica assessment after stabilization.
Never "wait and see." Early intervention prevents life-threatening complications.
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