Accidentally Swallowed Chicken Bone: Should You Get an Endoscopy?

Q: Accidentally Swallowed Chicken Bone: Should You Get an Endoscopy?

Hello： Ingesting chicken or fish bones can lead to two scenarios. <br>One is a scratch, which typically presents with milder symptoms and can be managed with medication. <br>The other involves the bone becoming lodged in the esophagus, leading to more severe symptoms affecting th

Accidentally ingested a chicken bone?

I went to the hospital for an X-ray of my throat, but nothing was found.
They also inserted a tube through my nostril for examination, and again, nothing was seen.
When they suggested scheduling an endoscopy, I refused out of fear.
Recently, I have been hesitant to swallow anything.
If something reaches my stomach, it will be digested, but if it doesn't digest, could it get stuck somewhere else? Should I go ahead with the endoscopy? I am now so fearful that I can't eat anything.

ROBIN, 20~29 year old female. Ask Date: 2012/05/30

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Ingesting chicken or fish bones can lead to two scenarios.
One is a scratch, which typically presents with milder symptoms and can be managed with medication.
The other involves the bone becoming lodged in the esophagus, leading to more severe symptoms affecting the gastrointestinal mucosa, which requires removal.
However, it can sometimes be difficult to distinguish between the two solely based on symptoms, necessitating further examination.
A throat X-ray may not always provide clear imaging, and often an endoscopy is required.
An otolaryngology endoscope is inserted through the nostrils, usually allowing visualization of the pharyngeal area; if the bone has entered the esophagus, an upper gastrointestinal endoscopy is needed.
The areas visible during an upper endoscopy include the esophagus, stomach, and the duodenum.
If a bone is seen, it may need to be extracted using instruments.
If the bone has passed into the intestines and is lodged in the intestinal wall, it may cause severe abdominal pain, requiring surgical intervention.
Clinical judgment is based on the current symptoms.
Wishing you good health, Dr.
Chi-Feng Chen, Taoyuan Hospital, Department of Health.

Reply Date: 2012/05/30

More Info

Accidentally swallowing a chicken bone can be a concerning experience, and it's understandable that you're feeling anxious about it. Based on your description, it seems that you've already taken some important steps by visiting the hospital for an X-ray and having a nasopharyngeal examination. Both of these procedures are useful in assessing whether the bone is lodged in your throat or esophagus. Since no obstruction was found in these examinations, it is possible that the bone has either passed through your digestive system or is in a location that is not easily visible on imaging.

When it comes to the decision of whether to undergo an endoscopy (esophagogastroduodenoscopy or EGD), there are several factors to consider. An endoscopy is a procedure where a flexible tube with a camera is inserted through the mouth to visualize the esophagus, stomach, and the beginning of the small intestine. It is particularly useful for locating foreign objects that may not be visible on X-rays or other imaging studies.

Reasons to Consider an Endoscopy:
1. Persistent Symptoms: If you continue to experience discomfort, pain, or difficulty swallowing, an endoscopy may be warranted to rule out any complications or to locate the bone if it is still present.

2. Fear of Complications: If the bone is sharp or large, there is a risk of it causing injury to the lining of the gastrointestinal tract. An endoscopy can help identify and potentially remove the bone before any damage occurs.

3. Peace of Mind: If your anxiety about the situation is affecting your ability to eat or function normally, undergoing an endoscopy may provide reassurance and help alleviate your fears.

Risks of Not Having an Endoscopy:
- Potential for Obstruction: If the bone is lodged somewhere in the digestive tract, it could lead to an obstruction, which can cause severe pain, vomiting, and other complications.

- Injury to the Digestive Tract: A sharp bone could potentially cause lacerations or perforations in the esophagus or stomach, leading to serious medical issues.

What Happens if the Bone Reaches the Stomach:
If the bone has passed into the stomach, it may eventually be digested, depending on its size and composition. However, if it is too large or sharp, it could still pose a risk of causing injury. Generally, small, smooth bones are more likely to pass without issue, while larger or sharper bones may require intervention.

Recommendations:
1. Consult with a Gastroenterologist: If you are still experiencing anxiety or symptoms, it would be beneficial to speak with a gastroenterologist. They can provide you with more information about the risks and benefits of an endoscopy based on your specific situation.

2. Consider Your Symptoms: If you develop new symptoms such as severe abdominal pain, vomiting, or blood in your stool, seek medical attention immediately.

3. Addressing Anxiety: It’s important to address your fear of the procedure. Many patients feel anxious about endoscopies, but they are generally safe and well-tolerated. Discussing your concerns with your healthcare provider can help you feel more comfortable.

In conclusion, while the initial examinations did not reveal any immediate issues, the decision to undergo an endoscopy should be based on your ongoing symptoms, anxiety levels, and the potential risks associated with the swallowed bone. It’s crucial to prioritize your health and well-being, so don’t hesitate to seek further medical advice.

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