Doctors from Peking Union Medical College say: If you have a fish bone stuck in your throat, are you still eating rice balls and drinking vinegar?

Friends who love to eat fish must have had this problem: a fish bone is stuck in the throat, and no matter how hard they cough, they can’t spit it out, so they start drinking vinegar, swallowing rice balls... They try all kinds of methods but nothing works. In fact, it is very common for fish bones to get stuck in the throat. In most cases, after the fish bones are removed, the human body itself is fine. But the statement that "getting stuck with a fish bone may be life-threatening" is not an exaggeration. Today, the otolaryngologist of Peking Union Medical College Hospital will introduce you to the treatment methods, common misunderstandings and prevention points after getting stuck with a fish bone——

About the author: Zhang Liqin

Resident physician in the Department of Otolaryngology at Peking Union Medical College Hospital, specializes in the diagnosis and treatment of common ear, nose and throat diseases.

Audit expert: Feng Guodong

Chief physician and professor of the Department of Otolaryngology at Peking Union Medical College Hospital, he is good at diagnosing and treating diseases such as otitis media and lateral skull base tumors.

Where is it easiest for fish bones to get stuck?

Fish bones can get stuck in any part of the body, from the time the fish enters the mouth to the time it is excreted. The most common places for fish bones to get stuck are, from top to bottom: tonsils, posterior pharyngeal wall, tongue root, epiglottic valley, pyriform sinus, and esophagus.

What should I do if I get a fish bone stuck in my throat?

1. Self-observation/others’ help (only applicable to adults with spacious pharyngeal cavity)

We need to open our mouth wide, press down the tongue with a blunt or flat tool such as a spoon, and keep making the sound "ah——". At the same time, observe whether there are fish bones in the tonsils and posterior pharyngeal wall on both sides. If fish bones can be seen, they can be removed with clean tweezers or other tools.

Some people have thicker tongues and a narrow pharyngeal cavity, so it is not recommended to observe this condition on your own. It is also not recommended for children to observe this condition on their own.

2. Visit the ENT department

If you or others cannot observe the fishbone, it is recommended that you go to the ENT department of the hospital for treatment.

You may experience the following:

In case 1, the doctor will first observe with an indirect laryngoscope, that is, pull your tongue out appropriately, use a small mirror to look deep into the throat, and if you can see the fish bone, you can remove it directly; if you have obvious nausea and cannot cooperate with the examination, you may need to complete an electronic laryngoscope examination, that is, use a thin and long soft mirror to enter through the mouth or nose to observe the deep throat. This examination usually does not cause obvious discomfort, so there is no need to be nervous. If a fish bone is seen under the electronic laryngoscope, it can be removed by inserting a small forceps through the side hole of the mirror (not all hospitals are equipped with this equipment, so it depends on the actual situation).

In case 2, no foreign body is found with indirect laryngoscopy or electronic laryngoscopy. Depending on the part of the patient that feels uncomfortable, the doctor may recommend that you complete a CT scan to check whether the fish bone is stuck in the esophagus. If the CT scan clearly shows that the fish bone is stuck in the esophagus, it may be necessary to perform foreign body removal surgery under esophagoscopy or foreign body removal surgery assisted by electronic gastroscopy. Once this happens, be sure to carefully consider the doctor's advice and follow it.

The consequences of a fish bone stuck

1. Foreign matter is stuck in the shallow part of the throat

Sometimes the fish bone does not penetrate into the soft tissue and may be spit out or swallowed by yourself. In this case, no treatment is needed. If the fish bone is clearly seen, it may cause mild mucosal scratches and discomfort in the throat after removal. At this time, please maintain oral hygiene under the doctor's advice, and the discomfort will usually gradually subside.

2. Foreign body stuck in the esophagus

• Seek medical treatment promptly. If a fish bone is stuck at the entrance of the esophagus, the foreign body can be removed through an esophagoscopy/electronic gastroscopy. Follow the doctor's instructions for postoperative treatment.

• If esophageal perforation has occurred, or the fishbone is located in close proximity to important blood vessels, the condition is serious and may require multidisciplinary experts to jointly develop a diagnosis and treatment plan.

3. No fishbone was found in electronic laryngoscopy or CT scan

Some patients may still feel a foreign body sensation and can be temporarily observed.

• If the injury is to a mucous membrane, the discomfort will gradually subside.

• If the foreign body sensation gradually worsens and obvious throat pain and swallowing obstruction occur, please seek medical attention immediately.

Common Misunderstandings

After getting a fish bone stuck in your throat, you should pay attention to the following points:

• It is recommended to stop eating and do not force swallowing. Do not try to swallow the fish bone with rice, etc. Doing so will only make the fish bone get stuck deeper, making it more difficult to remove.

• Drinking vinegar is really useless, you can try coughing, but it may not help.

How to avoid foreign body jams

• Other common foreign objects: date pits, chicken bones, duck bones, dentures, etc.

• Focus on eating and don't talk or laugh while eating.

• Do not eat in a hurry, especially when eating foods with bone spurs; avoid mixing food with other foods; when eating dates, it is best to remove the pits in advance.

• Elderly people’s dentures should be repaired promptly when they become loose, and they should be removed when sleeping.

Content from: Zhang Liqin, a doctor at Peking Union Medical College Hospital