Help I have a fishbone in my throat! What can I do?

Common sites fishbone can get stuck on:

1. Tonsil
2. Base of tongue
3. Pyriform fossa (side of throat)
4. Esophagus (Swallowing tube) 

Are home remedies useful in removing fishbone stuck in the throat?

Most home remedies are not useful and can potentially be dangerous in treatment of fishbones. 

Swallowing rice/banana to try to push it down can potentially make it lodge in a deeper position making it harder for it to be removed. Swallowing vinegar or acidic/fizzy drink does not dissolve the bone. Coughing hard to try to dislodge it can sometimes result in lacerations (tears) around the throat area with bleeding. Find out more about fishbone in the throat here https://www.medicalnewstoday.com/articles/326739.

What do doctors do to remove fishbone in the throat?

The ent doctor will check the oral cavity and throat area with a headlight and forceps to probe around the throat and see if it can be seen. A local anaesthetic spray can be used to make the process less uncomfortable. 

If the bone is not seen, a nasoendoscopy is done to check the deeper areas of the throat. This is a process whereby a tube with a camera attached is passed into the nose to look down the throat. Due to technological advances, the size of the nasoendoscope is small and the procedure is painless. 

If the nasoendoscopy does not show any bone, the next step would be to obtain an imaging scan either a lateral neck X-ray or a CT scan neck. 

Endoscope picture of a fishbone stuck deep down in the throat 

What should I do when I encounter fishbone in the throat?

Remain calm, you can test with a small sip of water to see if the throat is painful. If the throat is still painful or uncomfortable, it is safer to see an ENT specialist to check out the situation. If you have issues with fishbone stuck in your throat, consider visiting Dr. Dennis Chua.

How do I know when the fishbone in the throat is serious?

Fishbone stuck for more than 24hours have been shown to result in increased complication rate. If there are symptoms such as fever, blood stained saliva or chest pain, it could lead to serious complications. Please head straight to see the ENT specialist or Emergency Department. 

What are the complications of fishbone/ foreign body impaction in the throat? 

Once the fishbone is removed, the puncture wound usually heals quite well. Depending on the condition, oral antibiotics or anti-inflammatory mouth wash may be given to hasten recovery.
If the fishbone is left in place for more than a few days, it can start to migrate within the body. A migrated fishbone is a serious emergency that can have life-threatening complications. It can puncture vital organs or even big blood vessels within the body resulting in large amounts of bleeding. 

Sometimes foreign bodies that are not bones have been swallowed before and can also get lodged in the throat or esophagus. This was a pill box that was swallowed and was lodged in the esophagus.

References

1. https://pubmed.ncbi.nlm.nih.gov/28680494/
   Kasemsiri, P., Mahawerawat, K., Ratanaanekchai, T., Puttarak, W., & Munkong, W. (2017). The Accuracy of Digital Radiography for Diagnosis of Fishbone Foreign Bodies in the Throat. International archives of otorhinolaryngology, 21(3), 255–258. https://doi.org/10.1055/s-0036-1597811
2. https://pubmed.ncbi.nlm.nih.gov/29280900/
   Lu, Y. T., Chen, H. W., Tseng, Y. Y., Chen, C. H., & Lu, Y. C. (2019). Factors associated with the true location of ingested fishbones. European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 26(3), 224–227. https://doi.org/10.1097/MEJ.0000000000000527