Throat Numbness and Breathing Issues After Choking

Respiratory issues

Hello, doctor.
Recently, I choked on some Sichuan peppercorns while biting into them, and they accidentally went down my throat.
At that moment, I felt a numb sensation in my throat (previously, I had always bitten the peppercorns near my front teeth, which would also cause a tingling sensation).
I felt uncomfortable and a bit suffocated, and after taking a sip of water, I could no longer breathe.
I was very anxious, and fortunately, my husband was nearby.
He immediately performed the Heimlich maneuver, but it seemed ineffective.
Meanwhile, he asked my family to call an ambulance.
This process lasted about a minute, during which I initially couldn't breathe but eventually managed to take a small breath.
I remember forcefully coughing out a significant amount of gas twice (it felt similar to burping after a meal but deeper and more intense).
My face turned red, and I struggled, thinking I would die before the ambulance arrived.
Eventually, I gradually returned to normal.

Doctor, I have a couple of questions:
1.
In this situation, what methods can be used to resolve it? Since it wasn't a foreign object stuck in my esophagus but rather my throat being numbed, it seems the Heimlich maneuver didn't help.

2.
Are the throat/esophagus and nose part of the same respiratory system? If the throat is numb, does that mean I can't breathe through my nose either? (At that time, I vaguely remember being able to take a small breath through my nose but couldn't exhale.
I was very scared and anxious, and my memory of the sequence of events is a bit confused...) I couldn't find any information online about throat numbness caused by Sichuan peppercorns.
Thank you, doctor.

anna, 40~49 year old female. Ask Date: 2023/06/13

Dr. Zheng Jueyi reply Otolaryngology

Hello, a common cause of throat muscle spasms that can lead to difficulty breathing is irritation, rather than a foreign object lodged in the throat.
Therefore, the Heimlich maneuver is not appropriate in this situation.
It is advisable to remind oneself to try to slow down breathing and reduce excessive irritation to prevent the symptoms from worsening, and to seek medical attention immediately.

Reply Date: 2023/06/13

More Info

Choking incidents can be frightening and potentially life-threatening, as you've experienced. The sensation of throat numbness and breathing difficulties following an episode of choking on a peppercorn can be attributed to several physiological responses and mechanisms. Let’s break down your questions and provide some insights into the situation.

1. Methods to Resolve Choking Situations: In cases of choking, the Heimlich maneuver (abdominal thrusts) is typically the first line of action to expel the obstructing object. However, if the obstruction is not physical but rather a result of swelling or spasms in the throat, the Heimlich maneuver may not be effective. In such cases, the following steps can be taken:
- Stay Calm: Anxiety can exacerbate the situation, making it harder to breathe. Try to remain as calm as possible.

- Coughing: If you can still cough, doing so can help dislodge the object or stimulate the throat to return to normal function.

- Hydration: Drinking water can help soothe the throat and may assist in clearing any residual irritation.

- Medical Attention: If symptoms persist, it is crucial to seek medical attention. Emergency services can provide immediate care and assess for any potential injuries or complications.

2. Anatomy of the Throat and Breathing: The throat (or pharynx) serves as a passageway for both air and food. It connects the nasal cavity and mouth to the esophagus (for food) and the larynx (for air). When the throat is compromised, such as during choking, it can affect breathing. However, the nasal passages can still function independently to some extent. If the throat is numb or spasming, it may feel like you cannot breathe, but you might still be able to inhale through your nose. The sensation of not being able to breathe can be exacerbated by panic, which can lead to hyperventilation or a feeling of suffocation.

3. Numbness and Sensation: The numbness you felt could be due to several factors:
- Irritation or Trauma: The peppercorn may have caused irritation or a minor injury to the throat, leading to a temporary loss of sensation.

- Vagal Response: Choking can trigger a vagal response, which may cause a temporary slowing of the heart rate and a feeling of lightheadedness or numbness.

- Anxiety and Panic: The fear and panic associated with choking can lead to hyperventilation, which can cause tingling or numbness in the extremities and face.

4. Follow-Up Care: After such an incident, it is advisable to follow up with a healthcare provider, especially if you continue to experience symptoms like throat discomfort, persistent numbness, or difficulty swallowing. They may recommend:
- Throat Examination: A thorough examination of the throat and larynx to check for any residual irritation or injury.

- Swallowing Assessment: If swallowing difficulties persist, a swallowing study may be necessary to evaluate the function of the esophagus and throat.

- Referral to a Specialist: If symptoms are severe or persistent, a referral to an otolaryngologist (ENT specialist) may be warranted.

In conclusion, while choking can lead to immediate and alarming symptoms, understanding the anatomy and physiological responses can help alleviate some concerns. It’s essential to remain calm during such incidents and seek medical help if necessary. If you experience ongoing issues, do not hesitate to consult a healthcare professional for further evaluation and management.

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