Acute Aspiration of Oropharyngeal or Gastric Contents

What is acute aspiration of oropharyngeal or gastric contents?

Aspiration is a condition where fluids or solid particles (especially food) go into the windpipe or lungs (are inhaled or aspirated), instead of being swallowed into the esophagus and stomach. This can cause blockage of the airways and inflammation and infection of the lungs. It is more likely if there is a problem with the normal swallowing or gag reflexes. Symptoms may include coughing while eating, wheezing and shortness of breath. Toddlers and the elderly tend to aspirate more commonly, as do people who have had a stroke or brain injury, or who have other neurologic conditions. The outcome after aspirating depends on the substance aspirated, the age of the person affected and the presence of complications following the aspiration.

Risks

This condition tends to be more common among toddlers and the elderly. Certain medical conditions, especially those which affect the ability to swallow or the gag reflex significantly increase the risk of aspiration. These include problems with the development of the airways before birth, drowsiness, sedating drugs (including anesthetics and alcohol), and after a stroke or other brain injury, among other causes.

Symptoms

Symptoms may include a cough with eating, choking, shortness of breath, chest pain, wheezing, extreme tiredness, fever, and a blue tinge to the lips, fingers and feet.

Diagnosis

The diagnosis is based on the symptoms, a physical examination and a chest X-ray or CT scan. Other tests that may be useful include tests of swallowing function and testing the airway mucus for bacteria.

Treatment

Treatment depends on the severity of the aspiration. The aspirated objects or objects may need to removed by using a flexible camera to look at the windpipes. If pneumonia occurs, antibiotics might be given. In severe cases, the aspiration may cause severe damage to the lungs, and a machine to help with breathing (a ventilator) might be necessary to support breathing while the lungs recover.

Prevention

Most people can prevent it by having a strong cough. Physiotherapy can help to develop and maintain the coughing muscles. People with difficulty swallowing should get and follow advice from a speech pathologist on foods that are safe to eat to prevent aspiration. Avoiding some behaviors, such as excessive drinking and talking when eating, may help avoid some episodes of aspiration.