A sharp, sudden pain while eating fish signals that a small bone has lodged itself in the back of your throat, often near or in the tonsil. Fish bones are typically small, sharp, and irregularly shaped, making them prone to snagging on the mucosal lining of the throat and the crevices of the tonsils. The intense discomfort is caused by the bone pricking the sensitive tissue. Remaining calm is important, as panic can tighten the throat muscles and make removal attempts more difficult.
Immediate Steps and Safe Self-Removal Methods
A strong, forceful cough is often the most effective first step, as the rush of air can dislodge a bone that is lightly embedded near the top of the throat or tonsil. If the bone is not visible and does not clear with coughing, try introducing soft, sticky substances to gently grab the bone and carry it down.
A small piece of white bread soaked in water or milk, squeezed into a ball, and swallowed whole can work by creating a soft bolus that may encapsulate the bone. Other options include eating a small, mashed piece of soft food like a banana or a sticky marshmallow. These foods are dense enough to potentially adhere to the bone and push it into the esophagus toward the stomach.
You can also attempt to lubricate the area by sipping a tablespoon or two of olive oil, which coats the throat lining and may allow the bone to slide down more easily. If any of these attempts cause increased or sharp pain, stop immediately to prevent the bone from being driven deeper into the tissue.
Actions to Avoid When a Bone is Stuck
Never attempt to dislodge the bone by probing the throat with fingers, tweezers, or any other utensil. This action can push the bone deeper into the tissue, introduce bacteria, and create small lacerations, increasing the risk of swelling and infection.
It is also counter-productive to swallow large, hard, or sharp boluses of food, such as dry crackers or unchewed rice. Hard foods can exert excessive force, which may cause the bone to migrate and puncture the sensitive lining of the esophagus. Repeated, aggressive swallowing, especially if accompanied by severe pain, should also be avoided, as this can further embed the object. Home remedies involving acidic substances like vinegar are unlikely to dissolve the bone quickly and may cause irritation.
Recognizing When Professional Help is Necessary
Professional medical attention should be sought immediately if the bone is not dislodged within a few minutes or if severe symptoms develop. Seek emergency care if you experience severe, unremitting pain that prevents you from swallowing saliva, as this suggests a deep impaction or perforation. Immediate attention is also required for signs of a serious complication, such as coughing up blood or difficulty breathing.
A persistent sensation of the bone remaining after several hours, even if the pain is moderate, warrants a visit to an ENT specialist or an emergency department. If a fish bone is left in the tissue, it can lead to complications such as infection, abscess formation, or migration into deeper structures of the neck. Visible swelling in the neck or throat area, or the development of a fever, are signs of a potential infection that requires urgent diagnosis and treatment. Medical professionals can use specialized instruments, such as an endoscope, to safely locate and remove the bone without causing further trauma.