How bad can alkaline burns get? Gary Wasserman, MD, chief of the medical toxicology section at Children's Mercy Hospital in Kansas City, Mo., still remembers one from nearly 30 years ago. It involved a 2-year-old who got a taste of a caustic-cleaning agent, and suffered severe burns all through his esophagus and stomach, Wasserman tells WebMD. Over the years, the child underwent about a hundred medical procedures to deal with the extensive scarring. The injuries were so bad that doctors eventually created a new esophagus and stomach pouch using a portion of his bowel. He's in good shape today, Wasserman says.
Other products that can cause alkaline burns include bleach, oven cleaners, and toilet cleaners.
Scarring is the ultimate outcome of an alkaline burn, and small areas of scar tissue can be surgically removed. But drug treatment for these burns is still somewhat hit-or-miss. "Drug therapy is a little bit controversial, whether you give them steroids or antibiotics," Wasserman says. "Steroids interfere with scar formation ... but they can subject the patient to infection."
As for immediate home treatment of a child who has swallowed an alkaline solution, Wasserman says there is one main thing to remember: "If they're not choking, give a drink of milk or water. If they are, don't." The main worry is that the child might take into the lungs any additional fluid they can't swallow. That could set up a dangerous, and even fatal, form of pneumonia.
But as with any home poisoning, before doing anything, parents should contact the local poison control center.
Upon arriving at the emergency room, it may seem to parents as if the doctors aren't really doing much to a child who has swallowed these substances. Their first goal is to make sure the child is not in an immediately life-threatening situation that might require him to be put on a ventilator or other such measures. After that, doctors will try to perform a procedure called endoscopy, in which a specialist puts a camera down the child's esophagus to see the extent of the burns. Further treatment will depend on what the specialist sees there.