The gruesome images are a graphic reminder of just how far drug smugglers will go to elude law enforcement to get their product over the border. The images, which show an arrested man’s digestive tract that is literally stuffed with dozens of thumb-sized bags of cocaine, are also testimony to how far the digestive tract can expand.
“This is something someone does out of sheer desperation or fear,” said Dr. Eric Esrailan, vice-chief of the division of digestive diseases and an assistant professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles. “It’s not something anyone would do for any other reason. You have to assume that anyone doing this could potentially die, so they’re taking their lives in their own hands.”
The 20-year-old Irish man was arrested earlier Monday at a Brazil airport with 72 bags filled with nearly a kilogram of cocaine.
Esrailan has seen similar things — on a smaller scale — in the emergency room at his hospital. “There’s really nothing you can do except wait for things to pass through the patient’s system,” he said. “It’s not safe to try to retrieve them since you could do damage to the GI tract, or even rupture one of the bags.”
While it may look like the little bags are floating all through the man’s torso, they’re actually contained in the digestive tract, Esrailan said. The ones that look like they are in the chest are most likely in the stomach, which is just below the esophagus, he explained.
The rest are in various parts of the GI tract, which Esrailan says measures about 20 feet.
The digestive tract is built to expand, Esrailan explained. “If you’ve seen nature videos of snakes swallowing animals whole, you get the picture,” he said. “Peristalsis in the GI tract keeps moves things along.”
Most likely the bags seen in the images were swallowed one after another, said Dr. Adam Slivka, a professor of medicine and associate chief of the division of gastroenterology, hepatology and nutrition at the University of Pittsburgh Medical Center.
“They usually put the cocaine in condoms, believe it or not,” Slivka added. “You can carry an awful lot in your gastrointestinal tract -– as much as 10 pounds. The stomach has tremendous capacitance. When it’s empty it’s the size of your fist. When it’s full it can get to the size of a football.”
Between the stomach and the intestines you can hold a lot of little bags, Esrailan said. “That’s why these pictures look so dramatic.”
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Another trick smugglers sometimes depend on is gaming the speed of the digestive tract by stocking up on a few over-the-counter medications.
“You can take antidiarrheal medications and slow things way down and you can get constipation medications that move things along very rapidly,” he explained. “I guess if these guys time it right, they can pack an awful lot of stuff in there and then poop it out when they get through security.”
Even without the help of medications, things move through the GI tract pretty slowly, Slivka said. “The stomach normally empties in about an hour,” he explained. “The small intestine in four to six hours. Then it takes about one to two days to traverse the colon. But that’s very variable.”
The big problem for people who carry drugs this way — often labeled mules — is that bad things can happen once the little bags are inside the GI tract.
“It’s a pretty toxic environment in there,” Slivka said. “There’s a lot of stomach acid and enzymes that break things down. It’s disaster if one of the packets breaks open and all that cocaine gets released.”
Just think of how little cocaine it takes for someone to overdose and then look at how much is packed in each of those thumb-sized bags, he explained.
Linda Carroll is a regular contributor to msnbc.com and TODAY.com. She is co-author of the new book "The Concussion Crisis: Anatomy of a Silent Epidemic."
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