P2.114: "A Potential Solution For Water Bead Ingestion: Novel Use of Gastrografin Osmotically Shrinks Water Beads"

Background: Water beads are super-absorbent polymers (SAPs) which are widely used as sensory toys. They have also led to thousands of emergency department visits due to their accidental ingestion by children. Accidental ingestion can lead to choking, but even more severe complications such as bowel obstruction, and even death.

Due to their relatively small bowel lumen diameter, children are at higher risk of complications as the ingested water beads expand in their gastrointestinal tract. To address these complications, management often involves invasive procedures including endoscopic or surgical removal. However, non-invasive interventions to reduce bead size in vivo may provide an alternative or complementary solution. This study investigates whether certain solutions can reduce bead size and weight over extended periods to inform potential clinical applications.

Methods: In this extended experiment, water beads were initially soaked in normal saline (NS) for 30 minutes to simulate gastrointestinal conditions. Subsequently, beads were immersed in three hyperosmolar solutions: Gastrografin, MiraLAX, and 2% Milk, as well as one additional solution (Normal Saline) as shown in Figure 1. The bead diameter and weight were recorded at 1-hour intervals up to 6 hours. Statistical analysis (Welch’s two-sample t-test) was then performed using R studio to analyze and compare changes in diameter and weight for each solution relative to NS.

Results: Diameter changes (Figure 2a)
-Gastrografin resulted in the largest diameter reduction (p < 0.001).
-MiraLAX caused the largest diameter expansion (p < 0.001).
-2% Milk and NS exhibited more gradual increases in diameter, though less significant than MiraLAX.

Weight changes (Figure 2b):
-Gastrografin maintained a weight of ~0 grams, indicating minimal water absorption (p < 0.001)
-MiraLAX had the largest increase in bead weight, with beads expanding from 0g to >0.5g over six hours (p < 0.001)
-NS and 2% milk (p < 0.05) resulted in moderate weight increases.

Conclusion: This experiment provides evidence for the utility of Gastrografin as a potential non-invasive intervention to shrink water beads after ingestion. Its significant impact on reducing bead diameter and weight underscores its clinical relevance. In contrast, MiraLAX and other solutions were shown to consistently expand water beads, emphasizing the need for caution in their use for management. Future in vivo studies would prove beneficial to assess clinical outcomes, as well as potentially develop and optimize protocols for use of these solutions in pediatric patients after water bead ingestion. These findings suggest a promising avenue for non-invasive management of water bead ingestion, potentially reducing the need for invasive procedures in selected cases, though future study is needed.