Getting a Handle on Aspiration Pneumonia

What Is Aspiration Pneumonia?

Aspiration pneumonia is an inflammation (usually due to an infection) of your lungs and bronchial tubes that occurs after you inhale foreign matter. It’s also known as anaerobic pneumonia.

This condition is caused by inhaling materials such as vomitus, food, or liquid. This then leads to a bacterial infection. The bacteria are different, often more stubborn, from those seen in more common types of pneumonia.

What Causes Aspiration Pneumonia?

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Germs are the most common cause of pneumonia. This includes bacteria and viruses present in the air you breathe. Your immune system usually fights these invaders off, preventing them from infecting your lungs, but there are occasions where the germs can overpower the immune system. As a rule of thumb, pneumonia is classified according to the types of germs that cause it as well as where the infection occurs.

Under normal circumstances, only air should enter the airways of the lungs. Aspiration pneumonia occurs when you inhale food, drink, vomitus, or saliva into your lungs. Aspiration pneumonia is more likely if something is preventing your normal gag reflux. This can be due to a brain injury (which can occur due to stroke), a swallowing problem, or even excessive use of alcohol or drugs.

The causes of aspiration pneumonia include:

  • esophageal disorders
  • drinking large amounts of alcohol
  • comatose state
  • reduced levels of alertness
  • swallowing problems
  • anesthesia
  • aging
  • dental problems that interfere with chewing or swallowing
  • sedatives

Most people can prevent aspiration by creating a strong cough, but some people have an impaired coughing ability. This is especially common if people who are unconscious or have brain injuries because they have trouble swallowing foods or liquids properly.

Who Is at Risk for Aspiration Pneumonia?

Risk Factors

The highest risk of this condition is seen in older adults with a history of:

  • lung disease
  • seizure
  • stroke
  • dental problems
  • needing help eating
  • swallowing dysfunction
  • impaired mental status
  • neurologic diseases

People at any age can have certain additional risk factors. People with additional risk factors include those with:

  • a swallowing dysfunction who cough during meals or have difficulty breathing
  • a history of vomiting
  • a severe chronic illness that prevents them from chewing properly

People with heartburn and gastroesophageal reflux disease (GERD) also are at increased risk.

What Are the Symptoms of Aspiration Pneumonia?

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The symptoms of this condition are similar to other types of pneumonia. They include:

  • chest pain
  • shortness of breath
  • wheezing
  • fatigue
  • blue discoloration of the skin
  • cough, possibly with green sputum, blood, pus, or a foul odor
  • difficulty swallowing
  • bad breath
  • excessive sweating

If you have any of these symptoms, contact your doctor and let them know if you’ve recently inhaled any food or liquids.

Your doctor might find additional signs of aspiration pneumonia during a physical exam, such as:

  • decreased flow of oxygen
  • rapid heart rate
  • crackling sound in the lungs

How Is Aspiration Pneumonia Diagnosed?

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If you think you might have this condition, talk to your doctor as soon as possible. Prompt treatment can make a big difference in your recovery.

Your doctor will run a series of tests to diagnose you. These may include:

  • sputum culture
  • complete blood count (CBC)
  • arterial blood gas
  • bronchoscopy
  • CT scan of chest area
  • swallowing tests
  • blood culture
  • chest X-ray

Your doctor may also need to test your ability to swallow. Your doctor may ask you to take a barium swallow during your X-ray. This is called a barium swallow study, and it can give your doctor a better picture of any swallowing problems you may have.

How Is Aspiration Pneumonia Treated?

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Your treatment will depend on the severity of your pneumonia. The first line of treatment will probably be antibiotics. Severe pneumonia may need to be treated in the hospital. People with trouble swallowing may need to stop taking food by mouth.

Choosing the right antibiotics can be difficult. The bacteria that cause this condition may be hard to identify. There are some things your doctor will need to know to identify the appropriate medication:

  • whether you were recently hospitalized
  • your overall health
  • if you’ve used antibiotics recently
  • where you live

In severe cases, aspiration pneumonia can cause breathing problems, so you may need help to breathe. Mechanical ventilation may be used to assist with your breathing.

How Can Aspiration Pneumonia Be Prevented?

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You can reduce your risk of this condition by:

  • avoiding behavior that leads to aspiration, such as excessive drinking
  • recognizing the risks of aspiration in certain situations
  • receiving proper dental care on a regular basis

If your doctor has identified that you’re at risk of developing aspiration pneumonia, you should undergo a comprehensive swallow evaluation. A licensed speech pathologist or licensed swallow therapist evaluates this comprehensive test.

Those who are at high risk of aspiration pneumonia should drink alcohol in moderation. You should also make sure to follow your doctor’s orders when fasting before surgery. This will help lower the chance that you vomit while you’re unconscious.

Aspiration pneumonia is a very serious medical condition, but it’s treatable. If you’re at a high risk, it’s important to follow the prevention methods and to contact your doctor immediately if you notice any of the symptoms. Sometimes aspiration pneumonia can signal other underlying health problems. You have a better chance of making a full recovery if you catch it and get treated early.

What Can Be Expected in the Long Term?

Icon Outlook

Many people who have this condition also have other diseases that affect swallowing. Diseases such as Parkinson’s disease and amyotrophic lateral sclerosis (ALS) can affect recovery.

If you contact your doctor and get treatment promptly, this condition rarely causes complications. Your overall outlook depends on:

  • how much of your lungs have been affected
  • the severity of the pneumonia
  • the type of bacteria causing the infection

Without the right treatment, pneumonia can cause long-term problems. Lung abscess and inflammatory problems are potential complications. Some people will develop acute respiratory failure. This could be fatal.

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