6 Frequently Asked Questions - When you suspect a Fish Bone in the throat

Do I Have a Fishbone in the throat?

A suspected fish bone inside throat is one of the most common cases that ENT specialists see whilst on call. Singaporeans, and the older Chinese in particular, have a habit of putting the entire piece of fish, bones and all, into their mouth before picking out the bones one by one. The use of chopsticks to eat fish also contributes to this, as it is difficult to use pick out the bones before putting the fish in the mouth. This leads to a high incidence of fish bone in the throat. In Western countries, this is less common as most fish eaten have already been filleted before cooking. We relate the story of a patient who was seen recently for fish bone stuck in throat.


David, a 73 year old man, was eating fish for lunch using chopsticks when he thinks he swallowed fish bone. As per his friends’ advice, he tried to eat a clump of rice to push the bone down, but to no avail. He was not in too much discomfort, and managed to continue eating his lunch.

After his lunch, when he returned home, he still felt a niggling discomfort in his throat, but was unsure if he had swallowed a fishbone in the throat. He then tried gargling a cup of white vinegar to try and dissolve the bone, but to no avail. By this time, the discomfort had subsided and he decided to observe the situation for now.


When it was time for dinner, he was able to eat, but still felt some discomfort. To give himself some peace of mind, he decided to visit an ENT specialist for a review, and to see if there was truly a fish bone stuck in throat.


This patient was seen by us in the Accident & Emergency Department. He did not complain of any overt swallowed fish bone symptoms except for mild throat discomfort. An X-ray of the neck showed no fish bone in the throat. Examination of the mouth and the region of the tonsils revealed no fish bone in the throat. However, it is routine to perform flexible nasoendoscopy (putting a small flexible camera) down the nose and deeper down the throat, to rule out any fish bone in the throat further down, or foreign body in the throat. Flexible nasoendoscopy revealed a fish bone lying horizontally, stuck at the back of the tongue, in front of the voice box. This would not have been seen with a routine examination of the mouth and oral cavity.


Some topical anaesthesia spray was applied to David’s nose and throat, and the fish bone inside throat was removed with a pair of grasping forceps passed down the nasoendoscope. David’s symptoms were relieved, the fish bone in the throat retrieved, and he went home happy that he had made the decision to consult an ENT specialist, rather than leave the fish bone stuck in the throat overnight.

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Fish bone lying horizontally at the back of the tongue and behind the voice box

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Flexible nasoendoscope and grasper used to retrieve fish bone

Fish bone retrieved and returned to patient

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Fish bone seen stuck at the back of the tongue

Repeat X-ray after fishbone removal

Can a fish bone stuck in your throat kill you?

It depends. A swallowed fish bone stuck in the region of the tonsils and the bottom of the tongue, like in David’s case, is unlikely to kill you in the short term. However, fish bones can also be stuck lower down in the throat, and in the region of the food pipe (esophagus). Such fish bones, if ignored, can lead to symptoms such as an inability to eat and drink, and chest pain. In rare cases, these fish bones may extrude or migrate out of the food pipe into the neck and puncture the lung, or even large blood vessels causing death.

What happens if I have a fish bone stuck in throat for days?

Again, this depends where the swallowed fish bone is stuck. If the swallowed fish bone is stuck in throat in the region of the back of tongue or the tonsils, it could stay there for days with niggling symptoms. However, the longer the fish bone is stuck in throat, there is a greater chance of it causing complications or becoming infected.

How long can a fish bone stay in your throat?

There is no set time limit for a swallowed fish bone to stay in your throat if it is not removed. We have seen patients who have tolerated discomfort for a week or more before coming to see us and having the fish bone removed.

How do doctors get rid of a fish bone in the throat?

There are a few ways to remove a swallowed fish bone stuck in throat, and this depends whether the fish bone has entered the esophagus, or whether the fish bone is stuck in throat. In the latter case, it can usually be removed with a flexible nasoendoscope and a pair of grasping forceps. However, if the fish bone has entered the esophagus, this requires a general anaesthetic and removal with a rigid instrument.

What are symptoms of a swallowed fishbone in the throat?

The fish bone stuck in throat symptoms can vary greatly. In David’s case, he was in slight discomfort but still able to eat. Common symptoms would include persistent throat discomfort, blood-tinged saliva and a sensation of a lump or poking pain in the throat. If the swallowed fish bone has gone into the esophagus, the patient may experience chest discomfort or cough up blood stained secretions.

What are some home remedies that work to remove a fish bone in throat?

Various home remedies for a fish bone in the throat have been passed down over the years. This include eating large clumps of rice, gargling with vinegar to dissolve the fish bone inside throat, and sticking your finger down the throat to try and dislodge the swallowed fish bone. In our experience, none of these home remedies work and can potentially exacerbate the problem. Many patients ask if there is any medicine for fish bone stuck in throat; or will fish bone dissolve in throat. The answer to these questions, is a firm NO. For a suspected fish bone in the throat, it is best to seek medical attention at either a general practitioner or ENT specialist who can evaluate the condition accurately and provide treatment.

 

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