When eating fish, there is sometimes a risk of accidentally swallowing a fish bone. In some cases, the fish bone gets stuck in the throat.
What does a fish bone in the throat mean?
Fish bones are bony skeletal parts of bony fish. They include connective tissue ossifications, fin rays or ribs. Before eating edible fish, it is usually customary to remove the bones. However, it does happen from time to time that a fish bone is overlooked and swallowed while eating. This can cause the fish bone to get stuck in the throat or esophagus and cause discomfort. Due to its pointed shape, there is also a risk that the fish bone may get caught in the trachea and even cause the affected person to choke. However, this is extremely rare. Experts in ear, nose and throat medicine consider suffocation by a fish bone in the throat to be very unlikely and see no reason to panic. Thus, bones can be easily removed from the throat or esophagus by experienced ENT physicians with the help of special forceps or tweezers.
Causes
Caused by eating fish dishes, a fish bone gets stuck in the throat. Despite the removal of fish bones, it is possible for individual specimens to be missed and enter the throat or esophagus by being swallowed and become stuck. This does not usually result in a major problem for the human body. Thus, the bone slides down the esophagus together with the rest of the food mush towards the stomach. The hydrochloric acid in the stomach then causes the fishbone calcium to dissolve out, which in turn leads to softening of the fishbone. Just as with meat, further digestion of the fish bone then takes place. However, it is unpleasant if the bone gets stuck in the mucous membrane of the throat and cuts it with its tip. In some cases, there is also a risk of complications such as respiratory distress or bleeding.
Symptoms, complaints and signs
If a foreign body such as a fish bone gets caught in a person’s windpipe, the affected person reacts with a violent cough. This is a protective device by which an intruded foreign body is usually quickly transported out of the trachea. Often, when coughing, the patient perceives a sound when breathing. A strong coughing fit also sets in when the esophagus is affected. Some people who have swallowed a fish bone experience difficulty swallowing or a lump in the throat. Occasionally, severe pain may occur in the throat region. The pain is caused by the fishbone, which is similar in structure to a bone, boring into the mucous membrane of the throat. If the bone penetrates the epiglottis, which has the task of sealing the trachea, there is a risk of breathing difficulties. These can result from swelling of the affected throat area. In some people, inflammation at the puncture site is also possible, sometimes assuming larger proportions. Although such complications are extremely rare, they cannot be completely ruled out.
Diagnosis
Even after a fishbone gets stuck in the throat, there is usually no major danger. Thus, degradation of the tip of the bone occurs through the mucosal cells. This process, in turn, causes the remaining fish bone to break off. However, in some individuals, a visit to a doctor may be necessary if there is a major injury or if inflammation develops in the throat. A medical checkup should also be made for people in need of care who lack the strength to cough. While in 80 to 90 percent of all affected individuals, the fishbone passes back out of the body naturally, in 10 to 20 percent, medical treatment is necessary. At the beginning of the examination, the physician addresses the patient’s physical condition and checks for the possibility of complications. If the bone is still in the throat, the affected person sometimes suffers from pain, difficulty swallowing or discomfort. Swelling of the neck is considered a concern. An X-ray examination does not make sense in the case of a swallowed fish bone, because it cannot be seen on the image. Instead, a computed tomography (CT) scan can be performed to locate the foreign body. The course of a fish bone stuck in the throat is usually positive.Thus, the bony fish component is either naturally degraded from the body or removed by a physician using special instruments. Dangerous complications occur in very few patients.
Complications
A fish bone in the throat can be uncomfortable. In an unfavorable case, the stuck bone can cause bleeding or lead to inflammation in the throat. Breathing problems may occur due to a panic attack by the patient. However, it is extremely rare for patients to choke on a fish bone. Small bones can often be removed with a piece of chewed and swallowed bread. The body of the affected person tries to remove the fish bone through the mouth by coughing. If there are complications from larger fish bones in the throat, a doctor should be consulted. This removes the stuck fish bone with appropriate equipment. However, the fish bone stuck in the mucous membrane of the throat can cause a small injury in an unfavorable case. In itself, these heal on their own. However, a fish bone still stuck in the throat may cause pain and difficulty in swallowing. If the fishbone penetrates the epiglottis, shortness of breath may occur. Local inflammatory reactions and swelling in the throat may also occur. Such complications are rare, however, because larger fish bones are usually removed by the cook, or at the latest by the eater, usually before eating a fish dish. Only about ten percent of people who get a fish bone stuck in their throat require medical treatment.
When should you go to the doctor?
It is not always necessary to see a doctor for a fish bone in the throat. If the affected person is able to remove the fishbone from the throat by coughing hard, no treatment is necessary. Rinsing with water can also help. A doctor should be consulted in case of a fish bone in the throat if the affected person cannot remove the bone even after coughing for a long time or if the person loses consciousness and suffers from breathing difficulties. In this case, the emergency physician should be called or a hospital should be visited directly. If the person has lost consciousness, mouth-to-mouth resuscitation may also be used. A visit to the doctor may also be necessary if the affected person suffers from inflammation or swelling of the throat after removal. This may result in severe sore throat or difficulty swallowing. In most cases, the course of the disease is positive. However, in the case of swallowing, immediate action is necessary, because a fish bone in the throat can also lead to the death of the patient in the worst case.
Treatment and therapy
Swallowing a fish bone usually does not require major therapeutic measures. To make the bone slide on, it is recommended to drink plenty of fluids. However, acidic drinks or foods do not make sense. Although these are supposed to be able to dissolve the fish bone, they are not acidic enough for this purpose. Treatment by a doctor must take place if the patient suffers from an injury or inflammation in the throat. The first port of call may be the family doctor, who will pull out the bone with tweezers. However, a visit to a specialized otolaryngologist is considered more useful. This specialist has instruments that are suitable for removing fish bones. In addition, he sometimes anesthetizes the patient’s throat region with a local or general anesthetic to stop severe gagging.
Outlook and prognosis
A fishbone in the throat, although a frightening condition, is not dangerous in most cases. Fishbones are usually so fine and thin that they dissolve on their own over time, causing the uncomfortable feeling in the throat to disappear. This takes anywhere from a few hours to a full day. If you don’t want to wait for this, you can try drinking a glass of water while eating a few slices of toast in the meantime. Due to the swallowing movements of the esophagus as well as the food and liquid, a fish bone in the throat could already loosen on its own. At the latest, the stomach acid is aggressive enough to dissolve it in the stomach within a very short time. If necessary, the family doctor can be consulted. The doctor should be consulted at the latest if the fishbone causes pain, can still be clearly felt after a day, or if the patient can no longer swallow properly because of it.In rare cases, a fish bone actually sits so awkwardly in the esophagus that it causes serious swallowing difficulties or even leaves injuries. If it seriously impedes food intake or has left injuries, the option is to surgically remove it so that the patient can resume eating and drinking fluids as usual.
Prevention
There is no specific prevention against a fish bone in the neck. Thus, despite all precautions, it can be overlooked when eating.
Aftercare
A fishbone in the neck can be uncomfortable, which is why it should be removed quickly. Usually, the pain should stop after the fishbone is removed from the neck, yet it may continue for days to weeks. Care should also be taken to ensure that the entire bone has been removed and that no remnants remain in the neck. If pain persists, the patient should see the doctor again. The pain could then be controlled with analgesics such as ibuprofen or paracetamol. Furthermore, the wound can become infected with bacteria. In order to prevent an infection, prophylaxis with antibiotics can be useful, especially for immunocompromised persons. If an infection has already formed, antibiotics should be administered. If necessary, the infection may spread further and an abscess may form. This should first be treated surgically and then antibiotic prophylaxis should also be given. The patient should also be advised to avoid eating foods with bones or other irritating foods in the near future so that the inflammation formed by the bone can recede. If an infection has formed, the patient should return to the doctor for a checkup after antibiotic therapy.
What you can do yourself
If a fish bone is accidentally swallowed while eating, this is no reason to panic. Even if it is stuck in the throat, the affected person can usually solve the problem himself. For example, in many cases it helps to eat bread and drink water. Due to the pressure and consistency of the bread, a fish bone can often be removed before it causes any damage. The affected person also achieves a similar effect with marshmallows. Also, insofar as there is no significant discomfort, a little wait should be made. The cells of the esophagus quickly begin to decompose the fishbone, which is why in most cases it moves into the stomach on its own and is then dissolved. In the beginning, it is also possible to cough in order to provoke the fishbone to move out of the stomach. In addition, if the bone is quite high up in the throat or epiglottis, an attempt can be made to remove it using forceps. Under no circumstances should an attempt be made to move the bone by rubbing or squeezing the neck. This may result in deeper lodging. Eating or drinking acidic things is also not helpful. A sufficiently acidic substance to dissolve a fish bone would attack the tissues of the throat. Children should also be reassured, as swallowing a fishbone often causes panic. Only if shortness of breath occurs or the fishbone has not migrated after some time have self-help options been exhausted and emergency medical attention should be sought immediately.
