Your kindergartner comes to you while you are doing the laundry and calmly announces that Bret, your 2-year-old just ate a penny!Of the more than 100,000 cases of foreign body ingestion in the United States each year, more than 80% occur in children, mostly in kids between 6 months and three years. Toddlers explore their worlds with putting all kinds of things in their mouths.So what happens next with Bret? If he is wheezing, has developed a deep croupy cough or cannot speak or cry, call 911. These symptoms suggest the coin is trapped in the windpipe and needs to come out very quickly.Symptoms that require a prompt trip to the emergency room include gagging, drooling, spitting and chest pain. These symptoms sound as if the coin is caught in the esophagus, the food tube that leads from the back of the throat to the stomach. A physician evaluation and an X-ray will lead to a plan to go after the penny with a scope or to observe closely.Regardless of symptoms, some ingested foreign bodies require immediate evaluation: sharp objects, coins larger than a quarter, magnets and batteries of any type.The really good news is that almost 90% of all foreign bodies that kids consume pass in the stool in 2-5 days without any symptoms or medical help. Once the coin navigates the esophagus, the narrowest point of the G.I. track, it is usually free sailing to the diaper or toilet. It makes sense (and saves dollars) to strain the stool and find the culprit, therein avoiding additional medical care and X-rays.So, as the English philosopher once remarked: "Kid proof your toddler's home, Mum. Failure to be pence-wise may cost you lots of pounds."Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans.
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