Eating should be chewed and swallowed slowly, not "windswept clouds"

Uncle Zheng, who is in his seventies, likes to eat jujube produced in Xinjiang very much, and will add a few to boiled porridge, steamed steamed buns, and wrapped rice dumplings, and usually treats sweet dates as snacks
.
Not long ago, Old Uncle Zheng chewed jujube while talking to his family, and accidentally swallowed
the jujube kernel.
In order to get the jujube nucleus stuck in his throat, the old man swallowed rice balls, ate leeks, drank a lot of rice vinegar, and tossed for two or three days before going to the gastroenterology department of Linyi People's Hospital in Shandong Province
.
Kong Lingjian, an expert of the Chinese Food Think Tank and deputy director of the second ward of the Department of Gastroenterology of Linyi People's Hospital, was the expert of this reception, and after his detailed examination, he found that the sharp corner of the jujube nucleus had punctured the esophagus of the old man, and pus flowed out from time to time.

Foreign bodies are dangerous to get stuck in the throat

Kong Lingjian reminded that esophageal foreign bodies are a common disease in clinical digestive system emergencies, and animal, vegetative, metal and other foreign bodies caused by careless diet, accidental ingestion of foreign bodies or esophageal diseases are embedded in the esophageal lumen, and if not handled properly, they will induce complications such as esophageal perforation, esophageal bleeding, periesophageal inflammation, cervical and chest subcutaneous emphysema, mediastinitis and abscess, and tracheoeesophageal fistula
.
Severe cases can cause empyema and septic shock; If it ruptures into the aorta, it can cause acute massive bleeding and be life-threatening
.

Kong Lingjian introduced that the human esophagus has a total of upper, middle and lower three physiological stenosis, of which the first stenosis of the esophagus is located at the beginning of the esophagus, that is, the junction of the pharynx and the esophagus, where the nerves, blood vessels and muscles near the esophagus are very dense, and there is a trachea passing through, under the constraint of the thoracic entrance, resulting in various tissues closely arranged, so that the esophagus is the narrowest in this position, while the esophageal mucosal folds increase and enlarge, and pointed and irregular foreign bodies are difficult to be "released" here, and are most easily stuck.
It is therefore the most common site
of esophageal foreign body incarceration.
Secondly, foreign bodies are easy to stay in the second stenosis of the middle esophagus, this place is close to the aorta, once a sharp object pierces the mucosa, the esophagus can quickly appear inflammation and swelling, and then ulcers or perforations, forming periesophageal inflammation, mediastinitis and abscesses, if it is corroded by inflammation through the blood vessel wall, it can cause fatal hemorrhage, and is very dangerous
.
Therefore, esophageal foreign bodies here are often dangerous, especially sharp foreign bodies such as fish bones, which must be treated
as soon as possible.
Clinically, foreign body impaction in the lower esophagus is rare
.

Four of the most common reasons are the most common

In daily life, why do cases of esophageal foreign bodies often occur?

Kong Lingjian analyzed the following three reasons, one is that when adults eat in a hurry or are not concentrated, the food is swallowed without careful chewing, resulting in food clumps blocking the esophageal lumen or mistakenly swallowing jujube cores, fish bones, chicken bones, etc.
into the
esophagus.

Second, the elderly often suffer from tooth loss or use of dentures, poor chewing function, decreased sensation in the mouth, dysphagia, loose esophageal orifice, and easy to swallow foreign bodies
.

Third, children's pharyngeal protective reflex has not yet been developed, and the teeth are incomplete, it is not easy to discharge foreign bodies in the food, if you laugh and cry when eating, it is easy to swallow large pieces of food
.
And children like to have beads, coins, pen caps or small toys in their mouths, and they will swallow them if they are not careful
.

Fourth, if there are lesions in the esophagus itself, such as narrowing of the lumen caused by esophageal stenosis or esophageal cancer, it is difficult for foreign bodies to pass through and move, and it is easy to make foreign bodies stay and cause damage
.

Up to now, Kong Lingjian and his medical team have performed more than 500 cases of esophageal foreign body removal, among which the highest proportion of food clumps blocking the esophageal lumen is due to adults who eat in a hurry or are not concentrated; Children also have a higher
proportion of foreign objects such as magnetic beads and coins.

Kong Lingjian reminded that the elderly and children are prone to foreign body impaction of the esophagus, and must go to the hospital in time to remove the foreign body
.

Deal with the hidden dangers by yourself

Kong Lingjian said that from years of experience in endoscopic esophageal foreign body removal, there are various types of esophageal foreign bodies.

Animal foreign bodies are the most common, such as fish bones, chicken bones, pieces of meat, etc.
; followed by metal items, such as coins, paper clips, metal fragments, etc.
; In addition, there are chemical synthesis and plants, such as dentures, plastic bottle caps, rubber stoppers, small wooden strips, etc
.
The northern region of China is a jujube producing area, the jujube nucleus in this area is sharp at both ends, and it is very easy to stick in the esophagus after swallowing, and in the days before and after the Dragon Boat Festival in 2022, many patients who mistakenly swallowed jujube nuclei went to the hospital for treatment
.

Foreign body stuttering behind the esophagus can make people difficult to swallow, painful swallowing, accompanied by a feeling of foreign body obstruction, if the foreign body compresses the trachea or larynx greatly, especially pay attention to young children, it can cause difficulty breathing, and even suffocation
.
Kong Lingjian suggested that if the above situation occurs, you should see a doctor immediately, and avoid forcibly swallowing foreign bodies by swallowing rice balls, steamed buns, leeks and other homemade methods, so as not to aggravate the damage, lead to complications and increase the difficulty
of treatment.
For young children, there are two foreign bodies that are the most urgent, one is batteries, batteries are very dangerous, after contact with digestive tract fluid, it is extremely corrosive, and can burn the digestive tract in a short time, and even perforate
.
The other is magnetic beads, magnetic beads this small thing looks round and slippery without any edges, in fact, hides a lot of harm, if you accidentally eat two or more, they can be adsorbed together in the body, induce gastrointestinal necrosis and perforated internal fistula, life-threatening
.

Be careful to get to the point

In daily life, how should people prevent the embarrassment of esophageal foreign bodies? Kong Lingjian reminded that it is better to chew three minutes slowly than grab a second
.
When eating, chew slowly and swallow, avoid rushing, especially when eating food with fish bones or bones, you should carefully remove fine thorns and broken bones, and avoid mixing such foods with rice and noodles for cooking
.
At the same time, the elderly must strictly prevent denture loss, eat less sticky food, pay attention before meals, remove dentures before sleep and general anesthesia, and repair loose dentures in time
.

It should be emphasized that children's development in all aspects is still very immature, the esophagus and airway are narrow, and the swallowing function is not sound, to educate children not to put all kinds of small objects in the mouth to play due to curiosity, family members need to politely persuade after discovery, let the child quickly spit out, must not be forcibly taken out with fingers, so as not to cry or refuse to inhale foreign objects into the airway
.
Kong Lingjian warned that parents should pay attention to avoid giving children under 3 years old direct consumption of foods that are easy to get stuck, such as peanuts, jellies, nuts, chewing gum, fish bones, meat pieces, cherries, etc
.
If there is a need to eat, parents must carefully observe and demonstrate how to eat around their children, and if necessary, chop and grind such foods to prevent the possibility
of risks from the source.

A bite of food should be chewed at least 20 times in the mouth, 30 times is more scientific and reasonable
.
From the perspective of healthy eating, people need to change the bad eating habits
of "windswept clouds".
Regardless of men, women and children, eating should be calm, calm and elegant, because slowing down the rhythm of eating and drinking can not only effectively prevent foreign bodies from blocking the esophagus, but also fully taste the food
.

The ancients also had profound insights and unique experiences
of chewing and swallowing.
The "Daily Self-Chanting" once described it as follows: "Food must be chewed well, raw food should not be swallowed"
.
Ming Dynasty's "Yesterday's Fei An Ri Ling" cloud: "Eat carefully and swallow slowly, send it with jin liquid, and then the essence is dispersed in the spleen, the color is filled in the muscles, and the rough is only for the dregs to fill the intestines and stomach ears"
.
"Lao Lao Hengyan" believes: "There are three transformations in the stomach, one cremation, rotten boiling; Two mouthfuls, chewing also; Triple-abdomenization, into the stomach automorphic also"
.
"Words for Recovering from Illness" warns: "Regardless of porridge and rice snacks, it is advisable to chew it very carefully and swallow"
.

(Yi Xiaofeng)

Kong Lingjian is the secretary of the NOTES Group of the Colorectal Oncology Professional Committee of the Chinese Medical Doctor Association, and an associate professor of the Department of Gastroenterology of Linyi People's Hospital

China Food News(2023.
01.
12.
06).

(Responsible editor: Zhu Meiqiao)