Piece of Chicken Lodged in Throat (Anatomy Question)

In My Humble Opinion
1

The other thread got shut, but I’m curious what, exactly, is going on, when what happened to the OP happens.

It happened to me over Thanksgiving: big bite of (very dry) fried chicken, and it sort of lodged itself in the gullet, below the Adam’s Apple, right about the top of the sternum. It sat there, not going up, not going down, until, after a longish while, it slowly oozed down.

It felt like there was a sac or pouch in the esophagus. Is that it? Is there a “narrow place” that doesn’t like to pass a large bolus of food? Or is there a spasmodic constriction of the food passageway, that has to relax and open up again?

What causes this? What’s the best solution? (I found that taking tiny sips of my drink seemed to help lubricate it.)

2

You might want to look up a condition known as Schatzki’s ring. My mother had to have one corrected.

3

Or perhaps certain humans are evolving into cud chewing animals, and you’re one of them.

Congrats! You and Son of a Rich are branching off into a new species of humanity! A new epoch, all your own!

4

Zenker’s diverticulum aka pharyngoesophageal pouch is a distinct possibility.

5

Cool! Two factual answers…and an amusing one!

(My mama was one of those “chew eat bite of food thirty times” kinds of people. Alas, I’m a hasty eater…and this was the price to pay for it!)

Thank’ee all!

6

I’ve got an esophageal stricture that i need to have an esophageal dilation (throat stretching) done.

I’ve had food caught in my throat several times as a result. they call it “steakhouse syndrome”.

the key is not to let it happen (chewing well, drink plenty of water/ tea/ whatever & slow down).

if/when it does happen, sip diet coke. specifically diet coke. not other pop, diet coke. Google it, you can read for hours.

7

How about diet Pepsi? Or tea? (It was tea that helped me out.)

I Googled Steakhouse Syndrome and found lots of info; thanks! I was dismayed to see that some cites label it as a medical emergency…and that people have died of it. Ye cats!

Time to slow down and take smaller bites!

8

Here’s my adventure with a neighbor with an obstructed esophagus:

http://boards.straightdope.com/sdmb/showthread.php?t=817850

Moral: Call 911, these situations can go south real, REAL fast.

9

the one time i did go to the hospital for it I’d had the roast beef caught in my esophagus for 32 hours.

i was kinda fading out at that point, felt weak from lack of nutrients & i was dehydrated. they knocked me out & had a team of people in a well equipped room scope my throat & remove it with whatever they use.

later, like weeks later, i was doing some research & found there’s a way to attack the problem which doesn’t involve surgery. it involves using glucogon (blood glucose as i understand it) intravenously as a means of relaxing the entire digestive tract.

i looked at the instructions, warning label, disclaimer, …etc. sheet that comes in a glucagon kit a friends son keeps around for his diabetes & it had that listed as a useage.

i also found info on that approach at the national center for emergency medicines website. here’s the link to that

http://www.ncemi.org/cse/cse0602.htm

sometime after I’d learned of that way of attacking the problem it happened again.

when i went into the emergency room & told them i had food in my throat & I’d appreciate them making a non surgical attempt at getting it dislodged 1st & provided them with the info from the glucagon manufacturer & showed them the info I’d printed from the above link. (my reasoning was partly because it wasn’t as invasive &, mainly, i was paying for it out of pocket)

they said they refused to do it anyway other than surgically. their attitude was like i was asking them to do some crazy woo stuff that I’d overheard truckers at a strip club talking about.

that attitude & the just flat no without a rational, reasonable opinion or reason given as to why pissed me off a bit.

i left there, went & got the glucagon kit from the friends sons emergency kit & then found a phlebotomist (a friends neighbor) that was going to give it to me. while i was waiting for her to get home, the food became dislodged while i was walking around their block (nice night, exercise type walk).

i still don’t understand their compete reluctance to do what the research I’d done says is a reasonable, cheaper, safer approach, even if it’s not one with a guaranteed outcome.

10

warm. diet. coke.

it’s the carbonation that helps loosen the impact. diet coke is the number one fizziest stuff on the planet. tea is for sure not ideal due to no carbonation.

I’ve found the 20oz plastic bottles with a cap are the best. tiny sip, cap back on. stays fizzy longer.

11

The jury is still out on glucagon’s effectiveness. A few studies show it’s more effective than placebo and a few others show it to be only as effective as placebo. And a few experts recommend not using it for people with recurrent esophageal obstructive episodes, as there’s some evidence that these come from fixed obstructions in the esophagus which are less likely to respond to glucagon and more likely to rupture if left too long. Also, meat impactions are more likely to require manual extraction than other foodstuffs.

https://www.uptodate.com/contents/ingested-foreign-bodies-and-food-impactions-in-adults/abstract/48-51

In the end, it’s up to the doctor doing the treating to decide if giving glucagon a try is appropriate. And the doc deciding may have some good reasons not to. But the doc ought to share those reasons.

12

In about a dozen years of working in the ER, I’ve probably seen a few hundred cases of esophageal food obstruction and in all those years I’ve given just about every single one a dose of glucagon and had it work a grand total of 2 times.

13

I’ve seen a fair number of patients with impacted food bolus in the Emergency Department. They always seem to occur after hours so I’m waking up some grumpy GI doc who doesn’t want to come in. I always try the glucagon, but I’ve never seen it actually work. It’s main value for me is that I can then tell GI that I’ve already tried medical management and they’re going to have to come in and scope the patient.

14

yep, some reason, any reason, from someone seemingly knowledgeable on the procedure would’ve sufficed that night. instead, nothing. she wasn’t busy, didn’t consult with anyone above her, just read what I’d given her & made the call.

it wasn’t well recieved.

i really, really appreciate the feedback from you all.

thank you.