Dangers of forcing bones down throat

Swallowed fish bones rarely pose problems once they come into contact with digestive juices, but it is best to seek medical help immediately if a bone gets stuck in your throat.
Swallowed fish bones rarely pose problems once they come into contact with digestive juices, but it is best to seek medical help immediately if a bone gets stuck in your throat.PHOTO: ISTOCKPHOTO

Most people would have, at some point in their lives, accidentally swallowed a fish bone or two.

The discomfort would usually be short-lived, and goes away after a while. The good news is, fish bones rarely pose problems once it comes into contact with digestive juices and acid, said Dr Shalini Arulanandam, an associate consultant at the department of otolaryngology at Singapore General Hospital (SGH).

But if you ever get a bone stuck in your throat, it's best to seek medical help immediately.

Do not eat other food to try to "force" the bone down the throat, warn doctors. Contrary to popular belief, drinking vinegar does not help to dissolve fish bones either.

Once a fish bone gets past the throat, it is "very difficult" for doctors to locate it, said Associate Professor Siow Jin Keat, a senior consultant at the ENT clinic at Tan Tock Seng Hospital.

SMALL BUT DANGEROUS

Small, needle-like bones can migrate to other tissues... and cause immense problems, sometimes fatal.

ASSOCIATE PROFESSOR SIOW JIN KEAT, senior consultant at the ENT clinic at Tan Tock Seng Hospital.

  • RARE BUT SERIOUS COMPLICATIONS
  •  

    Fish bone stuck in the throat or oesophagus

    • Perforation of the oesophagus, causing saliva and food to leak into the neck or chest cavity, which can result in an infection.

    • If the fish bone migrates into the surrounding

    tissues, it may injure blood vessels, such as the aorta, a major artery in the body. There have been cases here where patients died from bleeding.

    • It may also cause life-threatening infections of the chest tissues, such as mediastinitis (inflammation of the tissues in the mid-chest). Neck or chest abscesses, which are collections of pus, may form.

  • Fish bone enters the gut

    • Perforation of the gut tissues.

    • A relatively big fish bone can get lodged in the narrow parts of the intestine, which may lead to pus formation and dangerous infections.

    • Fish bones may get stuck in the rectum and cannot be passed out, causing severe pain or infection.

The fish bone may also get embedded deeper - such that the end of the bone may no longer be seen sticking out of the mucus lining.

This means doctors may not be able to see the bone and pinpoint its location, said Dr Barrie Tan, head and senior consultant of the otolaryngology department at SGH.

The food may also get stuck above the bone and hinder its removal.

Said Dr Tan: "Even if the bone were to be dislodged, it may still get impacted in the oesophagus, which is a more dangerous location."

The course of the fish bone, once swallowed, also becomes unpredictable, said Prof Siow. "The bone will not give the patient any pain, so he may not seek medical attention."

While the bones get passed out naturally 99 per cent of the time, especially if they are small, some people may suffer dire consequences, such as perforation of the aorta, a major artery in the body, he added.

Ironically, swallowing big, odd-shaped bones is "safer" than smaller, needle-like ones, said Prof Siow, adding: "Big bones have problems getting past the oesophagus. They cause a lot of pain, prompting the person to seek medical attention... Small, needle-like bones can migrate to other tissues, such as into the neck, and cause immense problems, sometimes fatal."

Prof Siow, Dr Tan and Dr Tay Sok Yan, an associate consultant otolaryngologist at National University Hospital, offer some precautions to take to avoid swallowing fish bones in the first place.

•Reduce the frequency of talking and laughing while eating fish with bones.

•Remove fish bones on the plate - do not put a whole piece of fish in the mouth and use your tongue and teeth to "feel" for the bones and then spit them out.

•People who wear dentures should be doubly careful to check for bones. Chew carefully.

•Eat fish that has been filleted, as most bones would have been removed in the process.

•Do not mix fish with rice or noodles; eat it on its own.

•Mince the fish into small pieces so you can feel or see the tiny bones . Do not rush while eating fish with many bones.

A version of this article appeared in the print edition of The Straits Times on August 04, 2015, with the headline 'Dangers of forcing bones down throat'. Print Edition | Subscribe