Caustic substances poisoning

[Raeanne Dimick]

When swallowed, caustic substances can burn all tissues they touch—from the lips to the stomach.
Symptoms may include pain (particularly with swallowing), coughing, shortness of breath, and vomiting.
A doctor inserts a flexible viewing tube down the esophagus to look for burns and determine the severity of the injury.
Treatment is determined by the extent of the damage and may involve surgery.

(See also Overview of Poisoning.)
Worldwide, 80% of caustic ingestions occur in young children; these are usually accidental ingestions of small amounts and are often not very harmful. In adults, ingestions of caustic substances are frequently intentional, involve large amounts, and are life-threatening.
Common sources of caustics include solid and liquid drain and toilet bowl cleaners. Industrial products are usually more concentrated than household products and thus tend to be more damaging. However, some common household products, including drain and toilet bowl cleaners and some dishwasher detergents, contain damaging caustic substances, such as sodium hydroxide and sulfuric acid.
Caustic substances (strong acids and alkalis), when swallowed, can burn the tongue, mouth, esophagus, and stomach. These burns may cause perforations (holes) of the esophagus or stomach. Food and saliva leaking from a perforation cause severe, sometimes deadly infection within the chest (mediastinitis or empyema) or abdomen (peritonitis). Burns that do not perforate can result in scarring of the esophagus and stomach.
Caustic substances are available as solids and liquids. The burning sensation of a solid particle sticking to a moist surface (such as the lips) may prevent a person from consuming much of the product. Because liquids do not stick, it is easier to consume more of the product, and the entire esophagus can be damaged. Liquids also may be inhaled (aspirated) into the airways, leading to upper airway injury.