Beyond the Gut Feeling: A Retrospective Analysis of Adult Foreign Body Ingestion, Associated Risk Factors, and Treatment Outcomes

Background Adult foreign body ingestion (FBI) shows different patterns from pediatric cases and poses variable needs for endoscopic or surgical intervention, depending on object type, risk factors, and anatomical location. International guidelines recommend urgent removal for high-risk objects, such as sharp items, magnets, or batteries, and early endoscopy for selected esophageal impactions. To our knowledge, this study, for the first time in the United Arab Emirates (UAE), investigated the epidemiology, risk factors, management strategies, and outcomes of adult FBI cases at a tertiary hospital, comparing accidental and intentional ingestions. Methods A single-center, retrospective cohort of adults (≥18 years) presenting with confirmed or suspected gastrointestinal FBI between January 2017 and December 2023 was reviewed. Data on demographics, psychiatric and substance-use history, object type, location, management, complications, and outcomes were collected. The primary outcome was the need for endoscopic or surgical intervention. Comparative analyses used Fisher's exact and Mann-Whitney U tests. Results Forty-six patients with gastrointestinal FBI were included (25 accidental and 21 intentional). The median age was 31 years (interquartile range, or IQR: 27-43), and 52% were male. Intentional ingestion was strongly associated with psychiatric illness (95.2%) and substance-use disorder (85.7%). Overall, 33 of 46 (71.7%) patients required an intervention (endoscopy or surgery): 23 of 25 (92.0%) accidental vs. 10 of 21 (47.6%) intentional (Fisher p = 0.001). High-risk objects (sharp items and batteries) predominated among intentional ingestions, which had longer hospital stays (median: 5 vs. 1 day; p < 0.001). Conclusion Accidental FBI typically involves esophageal food impaction requiring prompt endoscopy, while intentional ingestion occurs mostly in psychiatric patients, involves high-risk objects, and exhibits recurrent, resource-intensive patterns. These findings highlight the need for structured triage pathways, early psychiatric involvement, and preventive strategies within mental health frameworks to reduce recurrence and hospitalization burden.