Outcomes of ingested superabsorbent polymers ("water beads"): A poison center study

Superabsorbent polymers (SAPs) are hydrophilic polymers that expand many-fold from their original size after contact with water. Ingestions of "water beads" by young children have been reported to cause bowel obstruction however, the incidence of bowel obstructions is unknown.

We conducted a retrospective study analyzing ingestions reported to our regional poison center from January 1, 2002 to April 25, 2023. The primary outcome was development of bowel obstruction. Secondary outcomes included development of symptoms, imaging, interventions, disposition, and outcome.

Of 256 cases reviewed, 217 met inclusion criteria, with 84 % of ingestions occurring in children under six years of age. Of the 217 analyzed cases, no patients developed bowel obstruction. No clinical effects were reported in 54.8 %, while 4.1 % had minor effects, and less than 1 % were coded with moderate effects. There were no cases coded with major effects or death. Fourteen patients underwent imaging which showed no abnormalities, and no patients were admitted to the hospital. Most patients (83.4 %) were monitored at home. Follow-up attempts were made in 53 % of cases, with an average of 45 h of follow-up time.

None of the patients reported to our poison center had abnormal imaging, required admission, developed a bowel obstruction, or required a procedure for foreign body removal. Though cases of bowel obstruction have been reported in literature, the incidence appears to be rare.

In our study, no bowel obstructions, admissions, or severe or fatal outcomes were documented, indicating a generally favorable outcome from SAP ingestions. Given reports of serious outcomes in literature, clinicians should continue to use clinical judgement to evaluate patients on a case-by-case basis for potential complications.