Lung Aspiration

What is lung aspiration?

Breathing a foreign substance into your airways is called lung, or pulmonary, aspiration. The substance could be food, liquid, medicine, mucus, or saliva.

Aspiration can cause choking. It can also cause a problem called aspiration pneumonia, which is a serious infection in the lungs.

What is the cause?

Normally, any material that is in the back of your throat is swallowed and goes into your esophagus, the tube that leads to your stomach. Your windpipe sits in front of the esophagus and leads to your lungs.

Swallowing is automatic and complex. It is coordinated with breathing to prevent anything in your throat from going down into your lungs. When this coordination is lost, aspiration can occur. Some things that can cause such a problem are:

  • Nervous system disorders, such as a stroke or multiple sclerosis
  • A defect in some part of the throat or vocal cords
  • A breathing disorder, such as chronic obstructive pulmonary disease (COPD)
  • Gastroesophageal reflux disease (GERD)
  • Medicines or surgery
  • Laughing or inhaling when food or fluid is in your mouth

People who cannot cough very well due to a stroke or other nervous system condition are at the highest risk of aspiration.

What are the symptoms?

The main symptom is choking or coughing before or after you swallow. Choking or coughing is the way that your body tries to remove something from the windpipe. Other symptoms can include a shortness of breath or wheezing that comes on quickly.

Many people have what is called a silent aspiration. This means they did not have any cough when they inhaled the foreign substance. It’s a common problem for people who have problems with swallowing.

How is it diagnosed?

You may be referred to a speech language pathologist who will observe how you swallow liquid and solid foods.

Aspiration can be diagnosed by a test called a videofluoroscopic swallowing study or video swallow. This must be done in a hospital radiology (X-ray) department. You are asked to swallow foods in various amounts and degrees of thickness (usually thin liquids, thickened liquids, pudding, and cookies or crackers) while in a sitting position. You may also be asked to swallow barium. An X-ray video is made that helps find where and when you have problems swallowing.

If your healthcare provider suspects that you have aspiration pneumonia, a chest X-ray is usually taken.

How is it treated?

There is no treatment for aspiration itself. Aspiration pneumonia is treated with antibiotic medicine.

How can it be prevented?

Follow these precautions to keep from breathing substances into your airways:

  • Don’t talk or laugh when you are drinking or have food in your mouth.
  • Limit the amount of food you put in your mouth at one time.
  • Avoid foods that you have trouble swallowing. If you have trouble swallowing a medicine, ask your healthcare provider if there is a different form of the medicine that may be easier for you to swallow.
  • Follow the therapies recommended for you if you have had a swallowing study.

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