Dates are sweet and nutritious and can be used to cook porridge, make dumplings and pasta, making them one of the most common foods in people’s daily lives. If someone accidentally swallows a date, what should they do? 1. How can I tell if I’m stuck with a date kernel? If a date kernel is swallowed by mistake, there is no pain in the throat and it is normal to drink or eat, which means that it has entered the stomach smoothly and is wrapped into a food ball, so it is safer; if there is more obvious pain and there is a blocking feeling when swallowing saliva, and the symptoms get worse with time, then it is possible that the date kernel is stuck in the esophagus, and it is necessary to go to the hospital for professional judgment by a doctor. 2.What preparations should be made before going to the hospital? When you suspect a foreign body in the esophagus, please stay calm: stop eating and drinking immediately, and keep fasting until the final diagnosis is made (unless there are special circumstances); preferably accompanied by a family member to the hospital; bring your medical insurance card, the visiting card of the hospital you are going to, medical record book, ID card and bank card; keep your communication tools open; bring your usual medication or emergency backup medication; if you have difficulty moving, you can call the emergency number and wait for You can call the emergency number and wait for an ambulance. 3.How should I choose a hospital? I once met a patient who complained to me as soon as he arrived at the emergency room, saying that he couldn’t see any of the 4 or 5 hospitals he went to, but it turned out that he went to some primary care institutions. Under our existing system, it is recommended to go to a large hospital designated by medical insurance for emergency surgery, especially for more specialized emergency surgery, so that you can take fewer trips. 4.What tests will the doctor recommend? Generally, doctors will choose esophagogram or CT examination, but individual tendency may vary. In a few cases, both may be required. 5.If it is found to be really stuck after examination, should I do gastroscopy or rigid esophagoscopy? Once a foreign body is diagnosed in the esophagus, the doctor will make a treatment plan for the patient as soon as possible, and then a question arises in front of the doctor, the patient and the family: whether to choose rigid esophagoscopy or gastroscopy? Personally, I recommend rigid esophagoscopy first. It requires general anesthesia, and because it has its own light source and a certain operating space, it is more widely available, especially when it comes to sharp or irregularly shaped foreign bodies. Gastroscopy, on the other hand, is a hose-scope that can be done under local anesthesia, with the disadvantage that the operating space is narrow and the operation is more difficult; if the foreign body is difficult to remove, improper operation of the gastroscope may even lead to more serious complications. Of course, the choice of treatment plan should never be rigid and dogmatic! Patients who are elderly or cannot tolerate general anesthesia can try gastroscopy first; for particularly dangerous foreign bodies, neck dissection or even open chest surgery is also one of the options. I once met a patient who was extremely resistant to general anesthesia and insisted on gastroscopy. As a result, not only did he not remove the foreign body, but eventually even the forceps of the gastroscope remained in the esophagus, which was also complicated by esophageal perforation and eventually had to rely on surgery to solve the problem. 6.Why should we take emergency surgery, can we do it a few days later? Once a foreign body in the esophagus is diagnosed, the doctor will arrange surgery as soon as possible. If the patient is seen during the day, surgery will be scheduled on the same day; if the patient is seen at night, the surgery may be performed at night or the next day. This is based on the length of fasting, the patient’s general condition, whether the preoperative workup is complete, whether there are underlying medical conditions that need to be treated before surgery (e.g., hypertension, diabetes, etc.), and the bed, among other factors. I have seen patients go home on their own because they thought it was a “minor problem”. But eventually they had to return to the hospital, and the delay was too long, and the wound became locally infected and septic, which greatly increased the risk of surgery. 7.Can I drink and eat immediately after the foreign body is removed? After surgery, we will give the patient fluids and anti-infection treatment (there are many bacteria in the digestive tract), so you cannot drink and eat right away. If on the 1st or 2nd day after surgery, the patient’s pain is significantly reduced, body temperature is normal, and neck pressure pain disappears, then you can gradually resume eating and drinking. The order is to drink water, rice soup, thin rice, noodle soup first, and gradually transition to normal diet. However, if the postoperative pain persists or worsens, there are signs of aggravation of infection in the neck, or the esophageal mucosa is more seriously damaged during surgery, the postoperative fasting time will be extended accordingly. The specific situation should be analyzed according to the actual condition and follow the doctor’s advice. 8.Why does the doctor advise the patient to review the gastroscopy after one month? A patient once asked me: “Dr. Zeng, my surgery was successful and I recovered well, why do you still make me suffer again? Gastroscopy is very uncomfortable!” I should say that I understand this sentiment, but clinical experience is very rational and sometimes very cruel. I have seen more than one patient who had esophageal cancer leading to esophageal stricture and then presented with a foreign body in the esophagus as the main manifestation. Therefore, I strongly recommend patients to review a gastroscopy after surgery to check whether there are any potential lesions in the esophagus to achieve early detection and early treatment. 9.How can I eat delicious dates without getting stuck? If you are eating dates as a snack, you should avoid talking loudly and playing while eating them, especially important for children, who must not play while eating to avoid accidental swallowing or aspiration. If you are cooking porridge, steaming pasta, etc., remove the pits from the dates during the preparation process! Be sure to remove the nucleus first! Be sure to remove the nucleus first! (I’ll say it three times). The reason is that many elderly people swallow the dates when they drink porridge and get stuck. 10. Besides date pits, what other things can get stuck in the esophagus? Which foreign body is the most dangerous? Other foreign bodies I have removed from the esophagus include fish bones, chicken and duck bones, food clusters, beer bottle caps, coins, crab shells, keys and dentures. These foreign bodies are the most dangerous because they often have metal hooks that can cause esophageal breakage, which can lead to choking, infection and even hemorrhage in severe cases. Therefore, for patients who need to wear dentures, we recommend that they must go to a regular medical institution to customize, and now dentures with metal braces have gradually been replaced; in addition, if the dentures are loose or unsuitable, they must be adjusted in time to prevent the risk of falling off.