Fish bones: a hidden danger that can choke you and cause serious complications.
Imagine the shock and fear Shirley Ballas, a judge on Strictly Come Dancing, experienced when a fish bone lodged in her throat, leaving her struggling to breathe for a terrifying 20 minutes. Thankfully, her hair and makeup artist came to the rescue with the Heimlich maneuver. But Ballas is not alone; even the late Queen Mother had a similar experience.
Fish bones are a surprisingly common reason for emergency room visits, especially in Asian countries where fish is a dietary staple. In fact, China has specialized clinics dedicated to removing these troublesome bones.
While fish are a great source of nutrients, they also contain small, delicate pin bones, usually found in the fillet. Cod, for instance, have around 17, and salmon about 30, but some fish can have over 100! Eel and flounder bones are also notorious for causing emergency room trips, with flounder bones being particularly dangerous due to their size and number.
Even with careful food preparation, these bones can sometimes slip through unnoticed. And when accidentally swallowed, they can lead to choking and other serious complications.
Fish bones typically get stuck in the tonsils, pharynx, piriform sinus (a small area involved in swallowing), and the oesophagus, the canal connecting the throat to the stomach. If you swallow a fish bone, you may experience coughing, a prickly sensation, difficulty swallowing, and even spitting up blood.
But here's where it gets controversial: sometimes, these bones cause no symptoms, and people can unknowingly live with them lodged in their throats for months. For example, a 69-year-old Japanese woman went to the hospital with a swollen neck, only to discover a 32mm fish bone that had been there for nine months!
Undiscovered fish bones can migrate around the neck, and repeated swallowing can even cause them to penetrate the oesophagus wall and move into the tight spaces in the neck. This poses a high risk to the many critical nerves and blood vessels that pass through the neck, including the carotid artery, a major blood supplier to the brain.
Bones can also pierce the thyroid gland, leading to abscesses, inflammation, and even sepsis, a rare but extremely dangerous complication. In some cases, lodged fish bones have migrated into the neck's muscles and under the skin, and even popped out through the skin, as happened to a Thai woman recently.
Any bones that migrate out of the throat are a surgical emergency, as there's no other way to remove them. These bones can also cause infections around the heart or migrate into the spinal cord, leading to secondary infections and potential paralysis.
So, if you accidentally swallow a bone, it's crucial to try and remove it as soon as possible.
Here are some methods to remove stuck fish bones:
- A forceful cough may help eject the bone, but be cautious as it could also dislodge it and allow it to pass into the stomach and intestines, where it may perforate the intestinal wall.
- Bones stuck in the oesophagus wall could potentially move through the body, but many cases will require endoscopic removal.
- Some suggest eating bread or a banana to force the bone down, but there's no scientific evidence to support this, and it could potentially block the airway or oesophagus further.
If coughing doesn't help and you still have symptoms, seek medical advice immediately. If you're unable to speak or breathe, abdominal thrusts may be necessary to dislodge the bone. In such cases, call emergency services and seek urgent medical support.
Remember, while fish bones are a tasty treat for some, they can be a choking hazard and lead to serious complications. Stay safe and enjoy your seafood responsibly!
