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This Thanksgiving, Promise Yourself: Don't Choke

Turkey on a Platter

Nov. 22, 2017 -- Before the holiday season starts this year, pledge to eat slowly and carefully. You might just save yourself a trip to the emergency room -- or save your life.

In a study published in February, researchers reported that people are 10 times as likely to get food stuck in their throats -- a condition called food impaction -- during holiday celebrations or while watching big games like the Super Bowl than they are at other times.

“Turkey was the most common food,” says the study’s lead author, Asim Shuja, MD, a gastroenterologist and fellow at the University of Florida College of Medicine in Jacksonville.

Risky foods include other meats and anything that’s not mushy, not soft, or that requires a lot chewing, says Shuja. Bones from poultry and fish can also get lodged in the throat. Shuja says that three behaviors explain most cases:

  • Eating too fast
  • Swallowing large pieces of food
  • Not chewing properly or thoroughly

Alcohol often adds to the problem, because it can make you eat more food less carefully, says Shuja. That might also explain why the holidays and other big events where food and drink are the focus can be dangerous.

Eric Lavonas, MD, agrees.

“When people drink too much while celebrating, that extra glass of wine puts them off their regular chewing routine,” says Lavonas, chief of emergency medicine at Denver Health and a spokesman for the American College of Emergency Physicians.

He says food impaction happens more often than choking. When food gets stuck, it can be very uncomfortable, but it rarely causes serious harm. But choking can cause death within minutes if untreated. In 2015, just over 5,000 people died from choking in the United States, according to the National Safety Council. It’s the fourth-leading cause of accidental death.

Shuja’s study examined the records of only one hospital, but other experts agree that you may be more likely to choke or get food stuck in your throat during food-heavy holidays like Thanksgiving. Adriane Lioudis, MD, a pediatrician at Cleveland Clinic Children’s, says choking sends about 12,000 children to the emergency room each year.

The foods that are risky for adults are also risky for children, says Lioudis. In addition to meat, children often choke on hard candy, nuts and seeds, and round foods like grapes and popcorn. Peanuts, she says, can be a big problem, especially for younger children.

“It is very important for them to eat while sitting calmly at a table and not to eat on the fly, which increases the likelihood of choking,” says Lioudis, who stresses that adults should be watchful during meals for kids of all ages.

Older adults have a higher chance of choking or getting food stuck if they have neurological problems, like stroke or dementia, that make it hard to chew and swallow, says Lavonas. He also points out that some medicines taken by older people prevent them from making enough saliva to easily move food.

“Drinking plenty of water while eating helps soften food and make it easier to swallow,” he says.

Shuja says that some people might be unaware they are at risk.

“They may have an allergic inflammation that they don’t know they have until they get a food impaction,” he says.

Such inflammation can cause the esophagus to tighten, making it difficult to pass larger pieces of food. It’s another reason to chew carefully and thoroughly.

If a piece of food does get stuck in your throat, don’t panic. Check your breathing and your ability to talk. If you can do both, says Lavonas, it’s not an emergency. Relax and take small sips of water or other nonalcoholic liquid. Often, that’s all that’s needed to move the food along.

Food that remains stuck requires a trip to the ER. A doctor can often treat the problem with a shot of glucagon, a hormone that relaxes the lower esophagus. That allows the stuck food to pass into the stomach. Lavonas says glucagon can also make you vomit, which may dislodge the food.

“Either way, it’s a victory,” he says.

When that does not work, a gastroenterologist must be called in to remove the blockage, often with a probe called an endoscope.

“It’s an easily treatable condition,” says Shuja.

In cases of choking, time is critical. If you can’t breathe, wave your hands, bang on something, or do anything else you can to attract attention and get help, says Lavonas.

Shuja recommends that one person attempt to help dislodge the obstruction while someone else calls 911.

“Don’t waste time,” he stresses.

The American Heart Association and the American Red Cross teach classes that include the Heimlich maneuver and other types of emergency first aid for choking. Parents, says Lioudis, can learn ways to safely help children of all ages.

But, each expert agrees, prevention is preferred.

“It’s pretty simple: Cut your food into small pieces and remove any bones, and chew carefully before you swallow,” says Lavonas.

WebMD Article Reviewed by Brunilda Nazario, MD on November 21, 2017

Sources

Eric Lavonas, MD, emergency medicine, Denver Health.

Asim Shuja, MD, gastroenterologist and fellow, University of Florida College of Medicine, Jacksonville.

Adriane Lioudis, MD, pediatrician, Cleveland Clinic Children’s.

American Heart Association: “Heartsaver CPR AED.”

American Red Cross: “First Aid/CPR/AED.”

National Safety Council: “Choking Prevention and Rescue Tips.”

News release, Nationwide Children’s: “New Study Finds Increase in Nonfatal Food-Related Choking Among Children in the U.S.”

Gastroenterology Report: "Esophageal food impaction during cultural holidays and national athletic events."

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