Swallowing a fish bone is a common and unsettling experience. While many instances are minor and resolve on their own, some can lead to serious concerns. Understanding the potential dangers and appropriate steps can help manage the situation and prevent complications.
Understanding the Potential Dangers
Fish bones, being sharp and sometimes oddly shaped, can become lodged in various parts of the upper aerodigestive tract. Common locations include the tonsils, the base of the tongue, and the piriform fossa, which is a recess on either side of the voice box. If the bone travels further down, it can also get stuck in the esophagus, the tube that carries food to the stomach.
When a fish bone becomes embedded, several complications can arise. The sharp edges of the bone can cause abrasions or perforations of the throat lining, leading to pain and potential bleeding. This injury can also introduce bacteria, potentially leading to an infection, such as an abscess formation in the neck or even the thyroid gland. In rare but severe cases, a bone lodged in the esophagus can obstruct the airway, causing difficulty breathing, or migrate into deeper tissues, potentially damaging major blood vessels or organs.
Symptoms indicating a bone is stuck include:
Persistent sharp pain
Difficulty or pain when swallowing
A tingling or prickling sensation
Coughing
A choking feeling
Excessive drooling
Swelling
What to Do and When to Seek Medical Help
If you suspect a fish bone is stuck, staying calm is important. A few gentle coughs may be enough to dislodge a bone stuck in the back of the throat or near the tonsils. Drinking water or carbonated beverages might help flush a small bone down, as the gases can help dislodge it. Eating a small piece of soft food, such as a banana, a marshmallow, moistened bread, or cooked rice, might also help by grabbing the bone and carrying it into the stomach. However, avoid forcefully trying to dislodge the bone with your fingers or aggressive swallowing, as this can push the bone deeper or cause further injury to the throat lining.
Seek immediate medical attention if discomfort persists for more than a few hours after home remedies, or if you experience symptoms such as:
Severe pain or worsening discomfort
Difficulty breathing
Persistent coughing or choking
Inability to swallow saliva or food
Bleeding
Fever
Signs of infection
A doctor, often an Ear, Nose, and Throat (ENT) specialist, can perform a visual inspection of the throat, or use a flexible endoscope with a camera to locate and remove the bone. In some instances, imaging like an X-ray or CT scan may be used to pinpoint the bone’s location, especially if it is not easily visible.
Minimizing the Risk
While accidental ingestion of fish bones can happen, several precautions can reduce the likelihood. Eating slowly and mindfully, along with chewing thoroughly, helps detect and remove any small bones before swallowing. Inspecting fish fillets carefully before cooking or eating can also help identify and remove any remaining bones.
Exercise extra caution when eating fish varieties known for having small, numerous bones, such as sardines, trout, or pike. Supervising children and individuals with dentures, who may have difficulty sensing bones, when they consume fish can further minimize the risk. Opting for deboned fillets whenever possible can also reduce the chance of encountering a fish bone.