Recognition and management of patients who repeatedly swallow foreign bodies

Repeated swallowing of foreign bodies, in adults, is part of a syndrome comprising personality disorder, drug overdose, and other self-inflicted injuries. The management should be conservative, as in many cases the foreign body will pass naturally or can be left in the bowel, if necessary for several years. Surgical intervention should be reserved for the complications of perforation, severe haemorrhage and persistent complete bowel obstruction, or for the removal of a toxic substance from the bowel. Five cases are reported which illustrate the natural history and management of the problem.