What happens when you aspirate?
Aspiration means you’re breathing foreign objects into your airways. Usually, it’s food, saliva, or stomach contents when you swallow, vomit, or experience heartburn. This is common in older adults, infants, and people who have trouble swallowing or controlling their tongue.
Most of the time aspiration won’t cause symptoms. You may experience a sudden cough as your lungs try to clear out the substance. Some people may wheeze, have trouble breathing, or have a hoarse voice after they eat, drink, vomit, or experience heartburn. You may have chronic aspiration if this occurs frequently.
Read on to learn what increases your risk for aspiration, complications, treatment, and more.
Some people refer to this as food “going down the wrong way.” This can happen due to reduced tongue control or poor swallowing reflexes. The average person can usually cough out a foreign object before it enters the lungs.
People who experience aspiration tend to have problems with swallowing due to:
|reduced tongue control||This can fail to trigger the swallowing reflex. It tends to cause aspiration of liquids.|
|abnormal swallow reflex||Without a swallow reflex, the food can roll and fall into the airway.|
|neurological disorders||Some neurological conditions, such as Parkinson’s disease, cause reduced tongue control.|
|esophageal disorders||These conditions affect the throat and swallowing abilities. They include gastroesophageal reflux disease (GERD), dysphagia, and throat cancer.|
|throat surgery||People who’ve had surgery or a condition that affects their larynx may have trouble swallowing. If the larynx doesn’t close tightly, food or liquids can enter the windpipe.|
|dental problems||This can interfere with chewing or swallowing reflexes.|
Aspiration during surgery
While you’re under anesthesia, content from your stomach may move up to your mouth and enter your trachea and lungs. Surgical teams are prepared for these moments, but it’s a good reminder to pay attention to your doctor’s orders to fast before surgery. Drooling after surgery is usually a sign of aspiration.
Symptoms of aspiration usually appear after eating, drinking, vomiting, or an episode of heartburn. They can be silent or overt.
Silent aspiration usually has no symptoms, and people aren’t aware that fluids or stomach contents have entered their lungs. Overt aspiration will usually cause sudden, noticeable symptoms such as coughing, wheezing, or a hoarse voice.
Silent aspiration tends to occur in people with impaired senses. In these cases, drooling or changes in the sound of their breathing and talking may be clues of swallowing difficulties.
Make an appointment with the doctor if you or someone you know experiences these symptoms after eating, drinking, vomiting, or an episode of heartburn, especially if they:
- have a neurological condition
- recently had throat surgery
- have throat cancer
- have problems with chewing or swallowing
Aspiration increases your risk for aspiration pneumonia. This is a condition where pneumonia develops after you’ve inhaled bacteria (through food, drink, saliva, or vomit) into your lungs. Too much liquid in your lungs can also result in a pulmonary edema, which puts a strain on your lungs.
In most cases, you won’t know you’ve developed pneumonia or pulmonary edema until you experience other symptoms such as difficulty breathing, coughing with mucus, and more.
People with health problems that affect swallowing are at a higher risk for aspirating. These health conditions include:
- impaired consciousness
- lung disease
- dental problems
- swallowing dysfunction
- impaired mental status
- certain neurologic diseases
- radiation therapy to the head and neck
Aspiration in older adults
Older adults are also more likely to have a condition known as dysphagia, which is difficulty swallowing. It’s common among stroke patients and adults with dementia, Parkinson’s disease, GERD, multiple sclerosis, or other neuromuscular conditions.
Older adults who need a feeding tube are also at higher risk.
Symptoms of aspiration may appear differently in children or infants. They may appear as:
- red face or grimacing facial expressions
- repeated lung infections
- slight fever after feeding
- weak sucking
Conditions that increase risk of aspiration in children and infants include:
- a cleft palate
- delayed growth because of premature birth
- Down syndrome
- cerebral palsy or neuromuscular diseases, such as spinal muscular atrophy
Children who aspirate have an increased risk for dehydration, malnutrition, weight loss, and other illnesses.
Treatment and outlook
Aspiration in children may get better over time, depending on the cause. Treating the cause will often improve aspiration. You can also minimize your child’s risk by:
- making sure they have correct posture during feeding time
- thickening liquids as recommended by your speech therapist or physician
- practicing swallowing exercises with them
- changing the type of food so it’s easier to swallow
- avoiding giving a bottle to a baby who is lying down
In severe and high-risk cases, your child may need a feeding tube to ensure they get enough nutrition until their condition improves. Talk to your doctor if you think your child has problems with aspiration. It’s important to check that aspiration hasn’t developed into a complication.
Your doctor will ask if you’ve experienced any symptoms of aspiration, especially after eating. If there are no symptoms, they may do a modified barium swallow test, which looks at your esophagus.
Your doctor will ask you to swallow a liquid that shows up on the X-ray to help them determine whether you have any underlying swallowing disorders.
Your doctor may also ask about other potential symptoms such as fever or chest pain to look for signs of pneumonia or pulmonary edema. They’ll also check for any problems with swallowing or underlying conditions such as GERD.
If they suspect aspiration has developed into another complication, they’ll order tests to see if there’s food or fluid in the lungs. These include:
Treatment for aspiration depends on the cause. Severe cases may require surgery. This may be to create a flap closure so food doesn’t fall in your airways. If someone aspirates while unconscious, turn them on one side. This helps fluids leave the body and lungs.
- Rest before your start your meals.
- Take small bites or cut food into smaller pieces.
- Swallow completely before drinking.
- Sit upright at 90 degrees when you eat.
- Choose food types that are easier for you to chew and swallow.
- Practice chewing and swallowing techniques, if provided.
- Visit your dentist on a regular basis.
- Avoid using sedative medications or medications that dry up your saliva before eating.
Anyone can aspirate. People with healthy lungs tend to cough up the content they’ve inhaled. People with an underlying condition are at a higher risk for aspiration to develop into something more serious.
The outlook for aspiration depends on the cause. For many people, swallowing therapy can help prevent aspiration. A session with a therapist usually lasts for one hour. Your doctor will recommend how many sessions you need.