Swallowing a small piece of paper is a common, usually accidental, occurrence. Paper is composed of cellulose fibers, a complex carbohydrate derived primarily from wood pulp. This material is the same as the insoluble fiber found in many fruits and vegetables. In most cases, a small amount of standard paper will pass through the digestive system harmlessly, providing immediate reassurance.
How the Body Processes Paper
The physiological journey of ingested paper is determined by the human body’s inability to break down cellulose. Humans lack the enzyme cellulase, which is necessary to hydrolyze the bonds linking the glucose units in cellulose, meaning the paper provides no nutritional value and cannot be converted into usable energy.
The paper moves down the esophagus and into the stomach, where strong acids and digestive enzymes attempt to dissolve it. Although the paper may disintegrate into individual fibers due to moisture and churning, the chemical structure of the cellulose remains intact. This undigested fibrous material then continues into the small and large intestines. Acting as roughage, the cellulose contributes bulk to the digestive tract, stimulating peristalsis, and the fibers exit the body mostly unchanged, incorporated into the stool.
Identifying Potential Complications
While the transit of a small piece of standard paper is typically uneventful, ingesting certain types or large quantities can introduce risks. One primary concern is physical obstruction, which occurs if someone swallows a large wad, a compact ball, or a significant volume of paper. This mass of indigestible material can potentially become lodged, causing a partial or complete intestinal blockage that prevents the passage of food and waste.
Another danger during ingestion is the choking hazard, especially for small children or individuals with swallowing difficulties. Thin paper that has been wet or chewed can become sticky or adhere to the throat, posing an acute risk to the airway.
Beyond physical issues, chemical treatments on non-standard papers present a toxicity risk. Papers with high-gloss coatings, bright dyes, or specialized inks, such as thermal receipt paper, can be problematic. Thermal receipts often contain Bisphenol A (BPA), an endocrine-disrupting chemical that can be rapidly absorbed if ingested. While standard printer ink is generally low in toxicity, consuming paper heavily coated in certain dyes or large amounts of toner powder is not advisable.
When Medical Intervention is Necessary
It is important to seek professional medical attention if specific symptoms develop following the ingestion of paper. Signs of a possible intestinal obstruction include the inability to pass gas or stool, severe abdominal pain or cramping, and persistent vomiting. Abdominal swelling and a decreased appetite also signal a potential blockage requiring urgent evaluation.
If highly toxic types of paper were consumed, such as a thermal receipt or paper saturated with chemical dyes, immediate consultation with a medical professional or Poison Control is advised. Even if obstruction symptoms have not appeared, the ingestion of chemically treated materials warrants guidance on potential systemic effects. Any difficulty breathing or persistent discomfort in the throat immediately after swallowing should be treated as a medical emergency.