• endoscopy
• endoscopic procedures

Foreign body ingestion is a challenging clinical presentation familiar to most gastroenterologists. In this edition of Frontline, Yadollahi et al report on a large series of such patients in their tertiary referral centre in Southampton.1 The authors describe an increasing incidence of foreign body ingestions over a 5-year period, discuss the outcomes of endoscopic management and relate the anticipated burden of this increasing presentation on staff and resources in their hospital.

This is a welcome and detailed addition to the small body of literature on the subject. The episodes of foreign body ingestion described by the authors of this article (who are all clinical gastroenterologists) are acts of self-harm. Terms such as ‘parasuicide’ and ‘deliberate self-harm’ have been superseded by this now preferred term. Foreign body ingestion is a small subset of such behaviours—the most common being overdose and cutting. Young people who self-harm have a substantially increased risk of adverse non-fatal and fatal outcomes, including suicide, compared with those who do not, yet most episodes of self-harm never result in a medical presentation. In a survey of adults from England aged 16–74 years, the prevalence of self-reported lifetime non-suicidal self-harm increased from 2.4% in 2000 to 6.4% in 2014, most notably in females aged 16–24 years, in whom prevalence increased to 19.7% in 2014.2 The reasons behind this remain unclear.

Self-harm is a complex behaviour and represents the final common pathway of a number of upstream risk factors. It can be a presentation of …