Food Stuck in the Esophagus

Go to the emergency department or call emergency services now if food is stuck and you cannot swallow saliva, are drooling, have chest pain, or have any difficulty breathing. Do not wait for it to pass. Food impaction means a piece of food (often meat) has lodged in the esophagus (the food pipe) and does not move down into the stomach. It is a medical emergency because the food can block the pipe completely and, over time, can damage the wall.

It is a common reason for urgent endoscopy. It can happen at any age, but is seen more often in people who already have a narrowing or an inflammatory condition of the esophagus. Children can also be affected, and in children the cause is often different.

Food usually sticks because the esophagus is narrowed or does not squeeze well. Common underlying causes include eosinophilic esophagitis (an allergic-type inflammation of the esophagus), a stricture (a scarred narrowing, often from long-standing acid reflux), a ring or web of tissue, and motility problems (when the muscles do not push food down properly). Eating quickly, poor chewing, ill-fitting dentures and large pieces of meat make it more likely. In children, swallowing small objects or toys is also a cause.

The history is usually clear. In hospital, the team checks your breathing and may take an X-ray if an object or a tear is suspected. The treatment and the diagnosis are often done together by endoscopy, a thin camera passed through the mouth under sedation. Once the food is removed, the doctor looks for the cause and often takes small tissue samples (biopsies) from the esophagus. Further tests may follow to check for reflux damage, eosinophilic esophagitis or a motility problem.

Most food impactions are removed safely at endoscopy. The most important step afterwards is to find and treat the reason, because without treatment it can happen again. Complications such as a tear are uncommon when treatment is not delayed.