Fish Bone Ingestion and Its Impact on Bowel Health - Gastroenterology and Hepatology

Fishbone and bowel issues?

Hello Doctor, I was diagnosed with COVID-19 and was in isolation from June 17 to 24.
On the evening of June 22, while eating mackerel, I swallowed a fish bone (approximately 1 cm long).
At that moment, I felt a slight prick but did not have a sensation of a foreign body, and I had no issues swallowing afterward.
I informed the clinic where I reported my COVID-19 diagnosis, and the physician suggested that since I felt fine, I could just monitor the situation.
However, on June 23 and 24, I experienced very dark green and brown stools, and during this period, I did not consume any liver foods or traditional Chinese medicine.
After reporting this to the original clinic, the physician promptly referred me to a larger hospital for further examination.
The ENT specialist performed an endoscopy but did not find the fish bone, while the gastroenterologist recommended a gastroscopy.

I would like to ask if there is a need to perform a fecal occult blood test.
Is it possible that the fish bone could have lodged in the intestines or other internal organs? Which department should I consult for these tests? If my only symptom is the dark stool color and I have no other discomfort—my blood pressure is normal, I have no stomach pain, palpitations, or dizziness, and my swallowing is normal—what other possible causes could lead to a sudden change in stool color? I admit I have read some news online and am feeling quite anxious, so I would appreciate hearing different doctors' opinions.
Thank you in advance!

Guo, 20~29 year old female. Ask Date: 2022/06/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

If convenient, a fecal occult blood test can also be performed.

Reply Date: 2022/06/25

More Info

Ingesting a fish bone can be a concerning experience, and it's understandable that you're feeling anxious about the potential implications for your bowel health. Based on your description, it seems that you swallowed a small fish bone while eating mackerel, and although you initially did not feel any discomfort, you later experienced changes in your stool color.

First and foremost, it’s important to note that while fish bones can pose a risk of injury to the gastrointestinal tract, many cases of fish bone ingestion do not lead to serious complications. The majority of small fish bones can pass through the digestive system without causing harm. However, there are instances where they can become lodged in the throat, esophagus, or even perforate the intestinal wall, leading to more serious conditions such as infections or abscesses.

The deep green or dark brown color of your stool could be attributed to several factors. One possibility is that it may be related to the digestion of the fish itself, especially if you consumed a significant amount of fish during that period. Dark-colored stools can also result from the presence of bile, which is a digestive fluid produced by the liver. If your body is processing a lot of fat or certain foods, it can lead to darker stools. Additionally, certain medications or supplements can also affect stool color.

Regarding your concern about the fish bone potentially causing an injury or being lodged in your gastrointestinal tract, it’s prudent to follow your doctor's advice for further evaluation. A gastroenterologist can perform a gastroscopy (upper endoscopy) to visualize the esophagus and stomach, and they may also consider a colonoscopy if there are concerns about the lower gastrointestinal tract. A stool occult blood test can be useful to check for hidden blood in your stool, which could indicate bleeding in the gastrointestinal tract.

If you are experiencing no other symptoms such as abdominal pain, nausea, vomiting, or changes in appetite, it is a positive sign. However, it is essential to remain vigilant. If you notice any new symptoms or if your stool color continues to change or if you develop any discomfort, you should seek medical attention promptly.

In summary, while the ingestion of a fish bone can be concerning, many individuals pass them without complications. The change in stool color could be due to various benign factors, but it is wise to consult with a healthcare professional for a thorough evaluation. If you have not already done so, consider scheduling an appointment with a gastroenterologist who can guide you through the necessary tests and provide peace of mind regarding your bowel health.

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