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Honey, Sucralfate Help Mitigate Button Battery Damage in Children

Here’s a sweet solution to the question of how to reduce esophageal damage when children swallow button batteries: honey.

Button batteries, which feature a small, candy-like shape and shiny metallic surface, are popular items to be swallowed by infants and children. Reacting with saliva and esophageal tissue, the battery creates a hydroxide-rich, alkaline solution that effectively dissolves tissue.

If a child presents to an ED after swallowing a button battery, the authors of a recent study advised both clinicians and parents/caregivers to direct patients to drink honey or sucralfate, marketed as Carafate, to limit caustic injury.

Children who have swallowed a button battery often present with symptoms of sore throat, cough, fever, difficulty swallowing, poor oral intake, or noisy breathing. Severe complications can occur, including esophageal perforation, vocal cord paralysis, and erosion into the airway or major blood vessels.

Investigators conducted experiments on cadavers and live animals to determine that honey and sucralfate created a physical barrier, as well as helping to neutralize the tissue pH increase spurred by battery ingestion. Honey and sucralfate both reduced injury severity better than other common household liquids, including apple juice, orange juice, sodas, sports drinks, and maple syrup, the study team reported.

"An esophageal button battery can quickly cause significant injury. We have identified protective interventions for both the household and hospital setting that can reduce injury severity," said Kris Jatana, MD, co-principal investigator and associate professor and director of Pediatric Otolaryngology Quality Improvement at Nationwide Children’s Hospital in Columbus, OH. "Our results will change the practice guidelines for how medical professionals acutely manage button battery ingestion."