The question of what happens when gold is swallowed is a common curiosity, often prompted by seeing the metal used as a luxurious food decoration or from the accidental ingestion of jewelry. The fundamental answer is that elemental gold, the kind found in flakes or solid pieces, is biologically inert. This means it does not react with the human body and is not a poison. The outcome of swallowing gold depends primarily on its chemical purity, which dictates toxicity, and its physical size and shape, which dictates the risk of obstruction.
The Chemistry of Gold and Toxicity
Elemental gold (Au) is classified as a noble metal due to its exceptional resistance to chemical attack. Inside the digestive system, it encounters hydrochloric acid in the stomach. Gold’s non-reactivity means it remains unaffected by this strong acid, unlike most other metals that would dissolve and be absorbed.
Since gold does not dissolve, it cannot be broken down by digestive enzymes or absorbed through the intestinal walls into the bloodstream. This lack of chemical interaction renders pure elemental gold non-toxic when ingested. It passes through the entire gastrointestinal tract without releasing any ions or compounds that could harm the body’s cells.
It is important to differentiate between inert elemental gold and gold compounds, specifically gold salts. These salts are highly reactive and were historically used in a medical treatment called aurotherapy for conditions like rheumatoid arthritis. Gold salts are toxic and can cause significant side effects because the gold is in an ionic form that can interact with biological molecules. However, these compounds are not found in edible gold or jewelry.
The purity of the gold is a major factor in its safety, measured in karats. Edible gold is typically 22-karat to 24-karat, meaning it contains minimal other metals. Lower-karat gold, such as 10k or 14k often found in jewelry, is an alloy containing metals like copper, nickel, or silver for hardness and color. If low-karat jewelry is swallowed, the chemical toxicity concern shifts to these alloyed metals, which can potentially leach into the body, though the physical risk remains the most immediate threat.
The Physical Journey Through the Body
For small, inert pieces of gold, such as decorative flakes or a tiny, smooth fragment, the journey through the body is purely mechanical. Since the gold is unabsorbed and undamaged by the digestive process, it travels the entire length of the gastrointestinal tract intact. The movement is governed by peristalsis, the muscular contractions that push food and waste through the intestines.
The majority of small, swallowed foreign objects, estimated at 80% to 90%, will pass completely without causing issues or requiring medical attention. Passage time typically ranges from four to six days, though individual transit times can vary widely. A small, dense object may take up to four weeks to be completely cleared from the system.
During this passage, the gold remains an inert solid mass within the digestive contents. Since it is not a nutrient, it provides no caloric or nutritional value. The small, flexible nature of edible gold leaf or flakes means they pose virtually no physical risk of causing a blockage or damaging the intestinal lining.
The process of excretion is the natural conclusion of the journey for swallowed gold, as the metal piece is simply expelled with the body’s waste. As long as the piece is small and blunt, the process is uneventful. A doctor may advise a patient to monitor their stool to confirm the object has passed, especially if the piece was larger or if the patient is experiencing symptoms.
Swallowing Different Forms of Gold
The outcome of swallowing gold depends entirely on the physical form it takes. Edible gold, applied to food and drinks, is manufactured as extremely thin sheets or flakes. The thinness and flexibility of these pieces prevent physical damage or obstruction. Their high purity ensures that no toxic metals are released into the digestive system.
The scenario changes when non-edible objects are swallowed, such as jewelry, a gold tooth, or a coin. In this case, the risk is mechanical, related to the object’s size and shape. The primary danger is that the object may become lodged in one of the natural narrowings of the gastrointestinal tract, such as the upper esophageal sphincter, the stomach exit (pylorus), or the lower intestine (ileocecal valve).
Medical intervention is required for blunt objects larger than 2.5 centimeters in diameter or longer than 5 to 6 centimeters, as these dimensions are unlikely to pass the stomach and small intestine. A second risk comes from sharp or pointed objects, such as an earring post or broken jewelry. These items carry a risk of perforating or tearing the lining of the esophagus or intestines, requiring immediate medical attention and often surgery.
If a large or sharp piece of gold is swallowed, medical professionals use an X-ray to determine its location and monitor its progression. Objects that are stuck or pose a perforation risk are typically removed endoscopically, using specialized tools inserted through the mouth. In rare cases where the object has caused a blockage or perforation, surgical intervention is necessary to remove the foreign body and repair the damage.