Resist the urge to inhale your favorite holiday meals — doing so could save you a trip to the emergency room

As the holiday season approaches and you prepare to scarf down your favorite festive dishes, remember to chew thoroughly. Doing so may help protect you from food bolus — also known as “steakhouse syndrome” or “backyard barbecue syndrome” — a blockage of food in the esophagus, or food pipe. When you have a food bolus, you can’t swallow food completely or regurgitate it, so the food can’t properly move through your food pipe and that can become a dangerous condition.

Below, C. Mobin Khan, MD, a BJC Medical Group gastroenterologist at Barnes-Jewish St. Peters Hospital and Progress West Hospital, shares more about causes of food bolus and what you should do if you suspect you have one.

What are the symptoms of food bolus?

Symptoms include chest discomfort, difficulty swallowing and the inability to control your saliva. It can feel very uncomfortable. It is also important to recognize the differences between food bolus and choking. People with food bolus don’t have interruption with their breathing — they have difficulty getting food down and cannot swallow their saliva, but they can breathe and talk. A person who’s choking can’t do either of those things.

What causes food bolus?

There are several common causes:

• Acid reflux can damage the esophagus resulting in narrowing and sometimes causing food to get stuck.
• Schatzki ring, a benign condition where scar tissue builds up in the food pipe, causing it to become narrow over time.
• Eosinophilic esophagitis, a condition that presents with small rings of scar tissue in the food pipe. Patients first recognize this condition after the periodic feeling of food going down the food pipe slowly and resolving by itself.
• Esophageal tumors and some other benign conditions can cause short periods of food getting hung up in the esophagus as well.

Are there certain foods that are more prone to causing food bolus?

The foods we see most commonly getting stuck are beef, chicken, pork and raw vegetables.

How do you treat food bolus?

If you have symptoms of food bolus, don’t try to eat on top of it. Don’t use carbonated beverages or effervescent tablets to try to get the food down because that increases the risk of aspiration into the lungs.

Food bolus can be treated by going to the emergency department (ED). Sometimes, the emergency department staff can provide medication that can relax the food pipe and allow the food to go down. If that doesn’t work, then an emergent upper-scope light-and-camera test called an esophagogastroduodenoscopy (EGD) can be performed under sedation. The food stuck in the esophagus is removed by using different instruments through the endoscope while the patient is sedated.

What should you do if you are experiencing difficulty in swallowing?

When a patient with food bolus arrives at the ED, doctors ask if they’ve experienced difficulty in swallowing multiple times before coming to the emergency room in the recent past. If they have, and if they’ve had it happen multiple times, then it’s best for them to make their primary care physician or gastroenterologist aware immediately. Patients then should seek medical attention and doctors will provide the appropriate treatment and recommendations to care for them.

Moving forward, patients should pay attention to symptoms of food bolus. They should especially be more aware if food is getting hung up in the esophagus after meals.

To learn more about digestive care, visit progresswest.org/Medical-Services/Digestive-Care.