Nearly 4,000 Americans visit the emergency department each year after a “foreign object” gets lodged in their rectum, official data shows.
An analysis, which is the first of its kind, estimated that between 2012 and 2021, 38,948 Americans ages 15 and older went to hospitals with the painful injury, the equivalent of about 3,895 a year.
Men accounted for nearly eight in 10 cases, with the most common group being men in their 20s and early 30s, who accounted for a third of all ER visits.
Sex toys accounted for more than half of the cases, while other items found ranged from toy balls or marbles to bottles, bottle caps, cans, drugs and even stationery.
Researchers from the University of Rochester, New York, found that men are more likely than women to come to the hospital with a foreign object lodged in their rectum. However, they suggested that this may be related to reporting bias, as women were less likely to insert non-sexual objects into their rectums, reducing the likelihood of their case being registered.
Above are the objects found in the rectum of humans. Writing utensils may include pens, erasers or sharpeners. Miscellaneous can be lightbulbs or even a World War I bomb
The age groups most likely to come to the hospital with a foreign body in the rectum are shown above
Researchers from the University of Rochester, New York, who conducted the study said there is a lack of hospital data on “retained rectal foreign bodies” in the US.
They were forced to conduct the study after data from Britain, Europe, Japan and the Caribbean suggested the injury was becoming more common worldwide.
Their work was published in the American Journal of Emergency Medicine last encountered and shared in Pub Med, the medical journal of the National Institutes of Health (NIH).
The team used data from the US National Electronic Injury Surveillance System database, which tracks all injuries related to consumer products or recreational activities recorded at 100 emergency rooms nationwide.
They singled out all cases that involved injury to the “pubic” or “lower trunk” involving a “foreign body,” and then selected those under the age of 15 or where the injury was unrelated to the rectum.
This produced a total of 886 cases of foreign objects lodged in the rectums during the 10-year study.
They then used national population estimates to extrapolate for the entire population, yielding a figure of 38,948 – or 4,000 per year.
Bottles, jars or bottle caps were the most common non-sexual devices found in people’s rectums, they found, accounting for 10 percent of cases.
They were followed by drugs, five percent, and a ball or marble, three percent.
Other objects reported were described as ‘writing implements’, or 2.3 percent, which may have included pens, markers and crayons.
In about 20 percent of the cases, it also involved ‘miscellaneous objects’. No details were given as to what these were, but earlier cases involved incandescent bulbs, dumbbells and even one World War I artillery shell.
About half of the incidents were related to sexual devices, such as sex toys.
By age group, people between the ages of 20 and 24 were most likely to be admitted to the ward with foreign objects in their rectum, followed by those aged 25 to 29 and those aged 20 to 34.
About 77 percent of the cases were recorded in men – or more than three-quarters of the total.
Scientists have not suggested why the objects ended up in people’s anuses, but rather this has been linked to sexual pleasure or satisfaction.
In the case of drugs, this could be related to people trying to smuggle them across borders or to events such as festivals for sale.
Estimates suggest that more patients are coming to hospitals with objects lodged in their rectums than before
Doctors may first try to remove the objects by manual extraction, or by gently manipulating the object to free it from the rectum.
When this fails, however, they deploy a range of other techniques.
This may include dilation, or inserting progressively larger cylinders to dilate the anal sphincter until the object falls out, or attaching forceps to an endoscope and inserting them into the rectum to grab the object and pull it out .
In more serious cases, doctors may be forced to perform surgery to remove the object.
Laxatives can also be used, but this is not recommended because the anal contractions they cause can push an object further into the body.
The researchers said their estimates also showed that more people were visiting hospitals with objects in their rectums.
In 2015, there were an estimated 2,433 hospital visits per year with this problem.
But by 2021, they suggested that number had risen to 5,230 a year — or more than doubled.
Researchers at the University of Rochester suggested that women are no less likely than men to experience problems with devices in their rectums.
Instead, they said their data may be due to publication bias.
Cases involving unusual objects were more likely to be recorded, they noted, but women were less likely to have non-sexual objects lodged in their rectums. They suggested that this would result in fewer cases being recorded.
Dr. Anthony Loria, a surgeon at the University of Rochester who led the study, and others associated with the paper, said: ‘These data quantify a common clinical presentation that has received little research focus.
‘Females are present at a younger age, have a significantly higher proportion of sexual devices, and have a lower chance of hospitalization.
“Conversely, the incidence among men is bimodal (has two maxima) peaking in the fifth decade of life, and the number of sexual devices is lower than among women.”
They added, “These data show that an exclusive focus on sexual aids would significantly underestimate the overall health care utilization associated with this problem, especially among men.”
The NIH said inclusion “does not imply endorsement or agreement of the contents” of the study, but that the journal’s scientific and editorial quality will have been evaluated as part of the publishing process.