From the Guidelines
If someone thinks they have food stuck in their throat but can tolerate their own secretions and has no airway compromise, they should first try drinking small sips of warm water or carbonated beverages to help dislodge the food, and if this doesn't work, seek medical evaluation, particularly if the sensation persists for more than a few hours. The initial evaluation should be based on the patient’s history and physical examination, including visualization of the throat 1. If the sensation persists, imaging studies such as a chest X-ray or CT scan may be ordered to identify any foreign body, with CT scan being particularly useful in cases of suspected perforation or other complications, and in patients with negative X-rays 1. In some cases, an endoscopy may be necessary, where a flexible tube with a camera is inserted to directly visualize the esophagus and remove any stuck food, and oesophageal biopsies should be taken at index endoscopy in patients with food bolus obstruction to diagnose eosinophilic oesophagitis 1. This evaluation is important because what feels like stuck food could sometimes be a symptom of other conditions like gastroesophageal reflux disease (GERD), esophageal spasm, or globus sensation (feeling of a lump without an actual obstruction) 1. If the person experiences increasing difficulty swallowing, inability to swallow liquids, drooling, vomiting, chest pain, or any breathing difficulties, they should seek immediate emergency care as these symptoms suggest a more serious obstruction. Key considerations in the management of food bolus obstruction include reassurance, assessment of the risk of perforation, and urgent interventional endoscopy to remove the food bolus and take oesophageal biopsies, with maintenance therapy with topical steroid reducing the risk of recurrent food bolus obstruction 1.
From the Research
Ruling Out Food Stuck in the Throat
To rule out food stuck in the throat, the following steps can be taken:
- Assess the patient's airway to ensure there is no compromise 2
- Take a thorough history and perform a physical examination to identify symptoms such as choking, gagging, vomiting, and dysphagia/odynophagia 2
- Consider imaging studies, with a plain chest radiograph being the preferred initial test 2
- If the radiograph is limited or there are concerns for perforation, computed tomography (CT) may be recommended 2, 3
- Endoscopy is the intervention of choice for complete obstruction, and medications should not delay endoscopy 2
Diagnostic Tests
Diagnostic tests that may be used to rule out food stuck in the throat include:
- Plain chest radiograph: the preferred initial test 2
- Computed tomography (CT): recommended if radiograph is limited or there are concerns for perforation 2, 3
- Endoscopy: the intervention of choice for complete obstruction 2
Medications
Medications that may be used to relieve esophageal foreign body impaction include: