Choking on food: How to quickly and safely handle it at home

The sensation of a lump in the throat, food getting stuck behind the breastbone, or difficulty swallowing can cause fear, pain, and reluctance to eat or drink. This could be a symptom of esophageal impaction (dysphagia); a survey of nearly 5,000 adults recorded that approximately 16.1% had experienced this condition.

Many people rush to find ways to clear a food blockage at home by drinking water or trying to swallow more, but this may not be appropriate if the food is completely stuck. In this article, Tiptory helps you recognize the signs that require emergency medical attention, understand common causes of esophageal impaction, and learn safe handling methods to prevent a "stuck bite" from becoming a bigger problem.

Managing Food Impaction in the Esophagus

Recognizing When Emergency Care is Needed

• If you experience a lump in the throat accompanied by difficulty breathing, inability to swallow saliva, continuous drooling, severe chest pain, cyanosis (bluish skin), or vomiting, call emergency services or go to the Emergency Room immediately.

• Do not attempt to swallow more food, drink large amounts of water, or induce vomiting to dislodge the foreign object. These methods can cause the food to become more tightly wedged or increase the risk of aspiration.

Seek Early Medical Attention if Esophageal Impaction is Suspected

• A sensation of food stuck in the throat or behind the breastbone, painful swallowing, or difficulty swallowing despite being able to breathe can be signs of esophageal impaction.

• Experts recommend visiting a medical facility the same day, especially if the food does not pass on its own after a short period. The doctor will assess the degree of obstruction and underlying causes such as esophageal stricture, prolonged reflux, or eosinophilic esophagitis.

Proper Treatment for Food Impaction

• The doctor may order a barium swallow X-ray or other appropriate tests if a foreign body or complications are suspected.

• Endoscopy is a commonly used method to remove impacted food or foreign objects, and to check for damage in the esophagus.

• In some cases, the doctor may use injectable glucagon to relax the esophageal muscles. However, medication does not replace endoscopy if food remains impacted.

• Surgery is only considered for complications or when endoscopy is ineffective.

Do Not Self-Treat Food Impaction with Carbonated Drinks

• Drinking carbonated beverages to "push" food down is not a standard treatment guideline and is not appropriate if you suspect esophageal obstruction.

• If you continue to feel a sensation of obstruction, recurrent difficulty swallowing, or unexplained weight loss, consult a gastroenterologist. Correct treatment of the underlying cause helps reduce the risk of improper food impaction treatment and recurrence.

Part 1: Causes of Food Impaction in the Esophagus

Food or Foreign Objects Can Obstruct the Esophagus

• Food getting stuck in the esophagus often occurs when swallowing large pieces of meat, dry/tough food, or eating too quickly without thorough chewing. Due to its dense nature, meat is prone to getting stuck, hence this phenomenon is sometimes referred to as "steakhouse syndrome."

• Fish bones, chicken bones, dentures, or accidentally swallowed objects can also cause esophageal obstruction. Individuals with a narrowed esophagus, prolonged reflux, or a history of recurrent swallowing difficulties are at higher risk.

Recognizing Signs of Esophageal Impaction

• A sensation of a lump in the throat or food stuck behind the breastbone, chest pain/pressure, or painful/difficult swallowing.

• Excessive drooling, coughing, choking, nausea, or a sensation of wanting to gag are important signs to note.

• If you cannot swallow saliva, have difficulty breathing, experience cyanosis, or severe chest pain, seek emergency medical attention immediately.

Do Not Self-Treat by Forcefully Swallowing

• Do not try to swallow more rice, bananas, other foods, or drink large amounts of water to push the stuck object down. This can cause the food bolus to become more tightly wedged or increase the risk of aspiration.

• Safe food impaction treatment requires assessment by a doctor, especially if the sensation of choking does not resolve quickly or recurs frequently.

Part 2: Why Do I Always Feel a Lump in My Throat?

Reason 1: Difficulty Swallowing Can Be Caused by Reflux

What is Dysphagia?

• Dysphagia is the condition of having more difficulty than usual swallowing food, drinks, or saliva. Patients often feel a lump in the throat, a sensation of something stuck in the chest or throat, or food moving down slowly.

• This sensation can occur when food is temporarily stuck, but it can also be related to esophageal impaction, inflammation, or narrowing of the esophagus. Do not self-diagnose the cause based on a single instance of a choking sensation.

Gastroesophageal Reflux Can Cause Dysphagia

• Gastroesophageal reflux disease (GERD) occurs when stomach acid and contents flow back into the esophagus, causing burning and irritation of the lining.

• If prolonged, inflammation can lead to scarring, narrowing the esophageal lumen and making swallowing more difficult.

When to See a Doctor?

• Consult a gastroenterologist if dysphagia recurs, worsens, is accompanied by weight loss, vomiting, chest pain, or a frequent sensation of food getting stuck.

• If you cannot swallow saliva, have difficulty breathing, experience cyanosis, or severe chest pain, seek emergency medical attention immediately. Do not attempt to clear a food blockage by forcefully swallowing more food or drinking water to push the object down.

Reason 2: A Lump in the Throat is Not Necessarily Choking

The Sensation of a Lump in the Throat Can Be Due to Globus

• Globus pharyngeus is the sensation of having food or a foreign object stuck in the throat or chest, even though no object is actually lodged there.

• This condition usually doesn't cause pain, but it can make the patient constantly feel a lump in the throat, want to clear their throat, or worry that they are experiencing esophageal impaction.

Distinguishing from True Esophageal Obstruction

• The globus sensation often varies with time, and the patient can still eat and drink normally.

• If there is actual dysphagia, painful swallowing, food getting stuck, weight loss, excessive drooling, or coughing/choking, a gastroenterologist should be consulted. This may not simply be a globus sensation, and one should not attempt to clear a food blockage at home.

Part 3: Safe Treatment for Esophageal Obstruction

Method 1: Glucagon May Help with Esophageal Obstruction

Doctor May Consider Glucagon Injection

• Glucagon is a medication that can relax the smooth muscles of the esophagus. In some cases of food stuck in the esophagus, doctors may use this medication with the goal of helping the food bolus move down into the stomach on its own.

• The medication should only be used in a medical facility after a doctor has assessed the condition of esophageal impaction, the degree of obstruction, and the risk of complications.

Glucagon Does Not Replace Emergency Treatment

• The effectiveness of glucagon is not uniform, and the medication is not a solution for all cases of a lump in the throat or swallowing difficulties.

• If you cannot swallow saliva, have severe chest pain, difficulty breathing, or food remains stuck, emergency endoscopy may be necessary to safely remove the food or foreign object.

• Do not self-purchase or self-inject glucagon to clear a food blockage at home.

Method 2: Endoscopy Helps Manage Esophageal Obstruction

The Doctor Will Locate the Obstruction

• When food stuck in the esophagus or a foreign object is suspected, the doctor will inquire about symptoms, conduct an examination, and order appropriate tests.

• In some cases, X-rays or barium swallows can help identify the location of the obstruction and detect complications. However, the choice of imaging method depends on the type of foreign object, the degree of esophageal impaction, and the doctor's assessment.

Endoscopy is Often the Primary Management Method

• Upper gastrointestinal endoscopy allows the doctor to directly visualize the esophagus, remove impacted food or foreign objects, and check for damage and the cause of dysphagia.

• When there is complete obstruction, inability to swallow saliva, severe chest pain, or difficulty breathing, urgent treatment is required. Do not attempt to clear a food blockage by forcefully swallowing more food or drinking water to push the object down.

Surgery is Only Used When Necessary

• Surgery is usually only considered when endoscopy cannot resolve the obstruction or when complications such as esophageal perforation have occurred.

• After treatment, individuals who have experienced a lump in the throat or recurrent food impaction should follow up to identify the underlying cause and prevent recurrence.

Part 4: Tips for Moving Stuck Food Down to the Stomach

Do Not Use Carbonated Drinks to Push Food Down

• If food stuck in the esophagus is suspected, do not attempt to drink carbonated soft drinks, sparkling water, or plain water to force the food bolus down.

• Although some mild cases may resolve on their own, drinking more when experiencing esophageal impaction can increase pressure, cause vomiting, or heighten the risk of aspiration. This is not a recommended method for clearing a food blockage at home.

Assess the Severity of Choking First

• If there's only a slight sensation of obstruction but you can still swallow normally, the symptom may not indicate complete esophageal obstruction. However, monitor and seek medical attention if the sensation of obstruction recurs.

• If you experience a lump in the throat accompanied by inability to swallow saliva, drooling, chest pain, coughing/choking, difficulty breathing, or cyanosis, seek emergency medical attention immediately.

The Safest Approach is Early Medical Consultation

• Do not attempt to swallow more rice, bread, bananas, or any other food to "push" the stuck object down.

• A doctor can assess the situation with endoscopy and remove the food or foreign object if necessary. This is a safer approach, especially for persistent or recurrent swallowing difficulties.

Choking and Difficulty Breathing Require Emergency Care

Call Emergency Services Immediately for Choking or Aspiration

• If you experience a lump in the throat accompanied by inability to speak, ineffective coughing, difficulty breathing, cyanosis, or loss of consciousness, call emergency services immediately.

• Do not wait for it to resolve on its own and do not attempt to drink water or swallow other food to push the object down. This could further obstruct the airway.

Provide Proper Support While Awaiting Emergency Services

• If the person can still cough and speak, encourage them to continue coughing; do not pat their back or intervene unnecessarily.

• If the person cannot breathe, speak, or cough, bystanders should perform proper foreign body airway obstruction first aid techniques if trained, and simultaneously call emergency services.

• After the choking episode subsides, if there is still a sensation of obstruction, chest pain, or difficulty swallowing, a medical examination is necessary to rule out esophageal impaction; do not attempt to clear a food blockage at home.

References

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3. Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. American Journal of Gastroenterology. 2022;117(1):27–56.
4. Sweis, R., Anggiansah, A., Wong, T., et al. British Society of Gastroenterology guidelines for oesophageal manometry and oesophageal reflux monitoring. Gut. 2019;68(10):1731–1750.
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7. Moloy, P. J., Charter, R. A. The dysphagia symptom questionnaire: a concurrent validity study. Dysphagia. 1989;4(3):130–134.

Content editor: Lesley Collins Tran.

Information consulted and verified by expert: Evelyn Clark.