Summary
Consequences of ingesting sodium hypochlorite — bleach, the most widely accessible caustic
Affiliation of the authors
DOI
Quote
Codinach-Martín M, Puiguriguer-Ferrando J, Planellas Giné P, Gispert-Ametller MA, Rodríguez Ocejo MC, Codina Cazador A. Consequences of ingesting sodium hypochlorite — bleach, the most widely accessible caustic. Rev Esp Urg Emerg. 2025;4:154–61
Summary
BACKGROUND. Sodium hypochlorite (bleach) is a caustic substance that can be found in most households in Spain.
OBJECTIVE. To analyze the consequences of bleach ingestion in patients treated in 2 emergency departments.
MATERIAL AND METHODS. Observational, descriptive, retrospective study of case records for patients who ingested sodium hypochlorite and were treated in 2 emergency departments over a 7-year period (2015-2021). We analyzed epidemiologic, clinical, and care variables as well as the extent of compliance with care protocols.
RESULTS. A total of 102 patients who ingested bleach were attended. Women with a mean (SD) age of 42.5 (24.7) years accounted for 61.2% of the visits; 15.7% of the patients were children, nearly all of them younger than 5 years of age. Sixty-five patients (63.7%) had ingested bleach accidentally. Fiberoptic gastroscopy, performed in 42%, revealed serious lesions (Zargar classification, > IIA) in 2 patients.
Computed tomography scans were ordered in 7.8%. Medical treatment was ordered for 82.3%, and proton pump inhibitors were the drugs prescribed in 92.9% of these cases. No patients required surgery. Symptoms were mild in 80.2% of the patients, but 19.9% were hospitalized (3 admitted to intensive care units). None of the patients died. Severity was associated with voluntary ingestion (suicide attempts) (P < 001); a history of heart disease or mental illness (P = .003); onset of digestive symptoms (vomiting) (P = .025); and epigastric pain (P = .037). Ingestion of diluted bleach, or accidental intake, were always associated with mild symptoms (P < .001). Overtreatment was evident in 38 cases (80.85%) in which care did not follow the protocol, although there were no important consequences.
CONCLUSIONS. Because bleach is the most frequently ingested caustic substance, its treatment should be governed by protocols. The prognosis is generally good, but physicians should be alert for suicide attempts, mental illness, and heart disease, as well as a presentation with digestive or oropharyngeal symptoms.