What do you hope to say soon after you’ve swallowed a Lego figurine head? Poop there it is.
But is it true that all things must pass or at least all Lego figurine heads must pass? And if so, how long will it take?
These are the key questions addressed by a study just published in the Journal of Paediatrics and Child Health. If you are saying, “but I don’t usually eat Lego figurine heads,” you are probably not 6 months to 3 years old. Because back in those glory days, chances are you were trying to put all kinds of stuff in your mouth, according to a publication in the World Journal of Pediatrics, aptly titled, “Foreign body ingestion: children like to put objects in their mouth.” In 2002, the UK had over 128,000 reported incidents of foreign body ingestion or aspiration with coins being the most commonly swallowed item by kids. But don’t worry, kids aren’t like Ponzi schemes. The money will likely get returned. A study published in the BMJ in 1971 finding that most coins get pooped out after 3.1 to 5.8 days with no real problems.
However, as the “Don’t Forget the Bubbles” team, which authored the Journal of Paediatrics and Child Health study, pointed out, there has been a dearth of studies on the “the second most commonly ingested item, nominally categorised as ‘toy parts.’” Therefore, the team consisting of Andrew Tagg (University of Melbourne Medical School), Damian Roland (Leicester Royal Infirmary), Grace SY Leo (Sydney Children’s Hospital), Katie Knight (Royal Hospital, London), Henry Goldstein (Lady Cilento Children’s Hospital), and Tessa Davis (Royal Hospital, London) used a website discussion forum to recruit study subjects who were pediatric hospital health care professionals and willing to swallow a Lego figurine head to answer the following question:
We’ve finally answered the burning question – how long does it take for an ingested lego head to pass?
— Tessa Davis (@TessaRDavis) November 23, 2018
They specified that the subjects could not have had previous gastrointestinal surgery, problems swallowing objects, or an “aversion to searching through fecal matter.” The study authors did not specify what they meant by “aversion” and where exactly during the conversation the “aversion” question arose. Six people eventually volunteered for the study.
Before they swallowed the Lego heads, each participant had to keep a 3‐day stool diary, which could be quite disconcerting if confused with a regular diary. The researchers developed a Stool Hardness and Transit (SHAT) score to measure the frequency and looseness of their stool. A higher SHAT score meant that the participant had more frequent and looser bowel movements, which could affect how fast the Lego head was you-know-what out of the person. Each patient has a pre-SHAT score, calculated for the 3-day period before the Lego head meal, and a SHAT score for the time between the ingestion and the pooping out of the Lego head. Thus, each participant was given 2 SHATs.
After the Lego head was swallowed, the next step was to keep track of the subsequent bowel movements and keep looking for the Lego head. The authors wrote that the “search was conducted on an individual basis, and search technique was decided by the participant.” In other words, each participant had to dig through his or her own poop. The researchers then tabulated what they described as the Found and Retrieved Time (FART) score. The FART score was just the number of days it took to pass and retrieve the Lego Head, but who can pass up the opportunity to say the word FART?
Here’s the poop on the 6 volunteers:
|Number of stools to retrieval||2||NA||3||3||1||1|
Why does Patient B have an “NA” for most of the entries? NA stands for “not available” but could mean “nada,” because even after 2 weeks this person could not find the Lego head in his poop. Somewhere a Lego body remains without a head.
For the other 5 participants, the FART score ranged from 1.14 days to 3.04 days for an average of 1.71 days. In other words, it took an average of about 41 hours for the Lego head to reappear. Incidentally, the team found no correlation between the FART and the SHAT, meaning the scores, that is.
Of course, this study had its limitations. This was a very small study with only 6 people and therefore did not represent the wide range of bodies and bowel dynamics that may exist in the population. In other words, will these findings hold with all kinds of SHAT scores? Plus, the participants were adults. And adults can be sort of different from 6 month to 3 year old kids, depending on the adult, of course.
Moreover, the authors pointed out that “the population studied could not be blinded to the study outcomes as we felt it was unfair on the authors’ partners or colleagues to search through their waste products.” Talk about high standards for partners and colleagues. The authors added, “We also recognize that the Stool Hardness and Transit score is not a perfect surrogate for underlying bowel pattern, but the fact that participants can SHAT themselves without specialist knowledge makes it an inexpensive tool.”
Of course, the study findings may not apply to other objects of different sizes and shapes, like action figures with arms, fidget spinners, and futons. Larger and less evenly shaped objects may get caught in the throat, esophagus, or the different sphincters, crevices, and curves in the gastrointestinal tract. This study also should not encourage you to swallow Lego figurine heads.
This study does offer some reassurance to parents and anyone who needs a Lego head to complete a body that such a small toy part will be pooped out without complications, typically in 1 to 3 days. The authors also added that “parents should be counselled not to search for the object in stools as it is difficult to find.” The bottom line is that if you or your kid swallows such an object, you may soon get to the bottom with it.