Aspiration and Aspiration Pneumonia

If you have a neurogenic disease such as Parkinson's, ALS,or Multiple Sclerosis,or you have a history of a stroke,or a history of head and neck cancer treatment, you may be at risk for swallowing problems (dysphagia). Your physician or speech-language pathologist may have recommended an instrumental swallowing assessment ( video-swallow study or fiberoptic evaluation of swallowing),be conducted to better assess the strength and efficiency of muscles involved in swallowing, and the ability of your vocal folds to protect you airway from aspiration. (aspiration is when secretions, food or liquid enter into the airway passing through the vocal folds).Aspiration normally triggers a cough, a protective reaction to material threatening the airway. Unfortunately, if the larynx has lost normal sensation,or cough power is weak, aspiration may occur without a cough, and we call this "silent aspiration." The primary symptom when aspiration is "silent", therefore, may be a fever, signaling the development of aspiration pneumonia, a serious illness, requiring antibiotics and sometimes hospitalization. If aspiration pneumonia is recurring,a stomach feeding tube may be recommended, as a means of providing safe nutrition.

You may wonder:does everyone who aspirates develop aspiration pneumonia? The short answer, would be no. Like a tropical depression developing in the Atlantic, the right conditions need to be in place for the development of a hurricane or "perfect storm." For a hurricane to develop, conditions include: the temperature of the water, the direction of the winds, and the land mass the storm travels over. The "perfect storm" of aspiration pneumonia also includes conditions such as:

• A serious illness or recent surgery
• Weakened or deconditioned muscles form disease or disuse as when recovering from a recent surgery
• Poor oral hygiene ( not brushing teeth or dentures) and bacteria from the mouth travels on secretions into the airway
• Poor cough effort or power which reduces the ability to clear material from the upper and lower airway
• Long periods of being bed bound and unable to feed oneself or move oneself
• The material aspirated can also be a factor, with water  aspirated in trace amounts being less harmful to the lungs than food particles

So, why do some people aspirate small amounts when eating or drinking and yet never develop aspiration pneumonia? Perhaps, they are resistant to the development of pneumonia because they have prepared their body for the impending "storm". Some characteristics of those individuals might be:

• They have strengthened and fortified muscles, including throat muscles with exercise
• They have performed respiratory strengthening exercise to improve their cough power or strength
• If hospitalized, they have worked with nursing, physical therapy, or speech therapy soon after surgery to regain muscle strength and cough power
• They have brushed their teeth or dentures daily
• They are non smokers

Your speech-language pathologist/swallowing therapist may provide you with specific exercises or swallowing techniques intended to reduce your risk of developing aspiration pneumonia. Adhering to those recommendations is important, and may be your best defense against developing more serious illness or help you with further recovery if already diagnosed with aspiration pneumonia.

The information contained herein should not be construed as medical advice, and is not intended to replace the medical advice of your physician or other licensed health care provider in your state. You should continue to consult your physician for matters regarding your health