Deliberate repeated foreign body ingestion
How to understand and approach this problematic phenomenon
Deliberate and repeated swallowing of potentially harmful foreign objects such as knives and batteries is characterised as impulsive, difficult to treat, and often results in urgent medical intervention. This behaviour has a major impact on the patient and their environment, placing significant pressure on healthcare systems. Problematic swallowing behaviour is most frequently observed in patients from early adulthood to middle age who are admitted to psychiatric hospitals, staying in prison institutions, and/or are mentally retarded. These patients usually have a traumatic history of sexual abuse and exhibit various forms of self-destructive behaviour. This phenomenon can be categorised into several diagnostic subgroups, including pica, nonsuicidal self-harm in personality disorders, simulation, OCD, and psychosis. In an emergency setting, predefined directives and multidisciplinary collaboration are essential to reduce stress and prevent further swallowing incidents. For long-term psychiatric care, various psychopharmacological treatments and psychotherapeutic interventions are advised. Adequate support and training of practitioners is recommended, given the severity of care required for these vulnerable patients.