What is Aspiration, Know its Causes, Symptoms, Risk Factors, Complications

Aspiration is medical terminology for accidental inhalation of foreign objects or fluid into the windpipe and lungs which may lead to coughing, choking, difficulty in breathing, and discomfort. Aspiration is more common in older adults, infants, or people who have trouble controlling their tongue and those who are intubated.⁽¹⁾

Aspiration is of two types:

Pulmonary Aspiration: A condition in which a foreign substance lodges into the windpipe and lung. It often occurs when while eating or drinking, the substance goes down the wrong way or when someone breathes in water, saliva, smoke, or stomach content such as vomit.

These substances block the airway partially and lead to lung irritation that may cause coughing or difficulty in breathing.

Aspiration Procedure: This is a medical procedure in which the suction tube or needle is inserted by a healthcare professional to remove harmful fluid from the lungs, joints, organs, or tissue. Sometimes aspiration is also done to take sample fluid to test for the signs of infection or cancer cells.

Mostly aspiration can be due to the following causes:

There are certain medical conditions such as Parkinson’s disease or advanced dementia that reduce tongue control and cause abnormal swallow reflex. There are also conditions such as stroke, brain injury, and intracranial tumor that can reduce tongue control and cause swallowing issues.

Conditions such as gastroesophageal reflux disease, dysphagia and throat cancer can affect the throat and swallowing abilities.

People who have undergone surgery or any condition that affects the larynx may lead to trouble swallowing. Larynx if do not close properly increases the risk of fluid entering the windpipe.

These problems can interfere with chewing and swallowing and can increase the risk of aspiration.

Other than these problems aspiration is also a medical procedure as discussed above.

There are a few symptoms that can be observed when a person aspirates something into the airways. The substance irritates or partially blocks the airway and leads to:

• Coughing
• Wheezing
• Painful swallowing
• Hoarseness of voice
• Sensation of something is stuck
• Difficulty in breathing

It is observed that most people aspirate something into the lungs and there are certain issues that increase the risk. A study was conducted in which it was observed that aspiration was more common in people who experienced a stroke at least once.⁽²⁾

It is also observed that people with the following conditions are more at risk of aspiration:

• Impaired or gag reflex
• Reduced physical mobility
• Dysphagia or difficulty in swallowing
• Neurological disorder

Additionally, intoxication, dementia and gastroesophageal reflux are also a few factors that increase the risk of aspiration in a few people.

When harmful substances enter the lungs there can be additional problems. When someone aspirates harmful bacteria into the lungs it can result in infection and inflammation that characterize a condition called aspiration pneumonia. This can lead to coughing, fever, fatigue, coughing of blood or sputum, and breathing difficulties.

Chemical pneumonia can result when toxic fumes are aspirated.

Aspiration is a common problem in children and is noticed when the child chokes and develops a cough.⁽³⁾

A study reviewed 102 children who underwent an endoscopy and developed symptoms of aspiration. It was found that among them 49 children aspirated nuts or seeds.⁽⁴⁾

The symptoms in children are not the same as adults and may include:

• Weak sucking
• Wheezing
• Frequent chest infections
• Grimacing expression
• Feeding problem
• Difficulty in breathing and feeding

Cleft palate, neurological conditions, prematurity, chronic disease, and gastro-esophageal reflux disease are a few risk factors that may cause aspiration in children.

The condition can be treated with medications, speech therapy, occupational therapy, and surgery.

The treatment for aspiration totally depends on the severity of the reason behind it and in some cases treatment is not necessary.

• Bronchoscopy is needed in the case where a piece of food is still in the lungs.
• Antibiotics are prescribed in the case of people with aspiration pneumonia.
• Speech therapy is recommended if a person has problems swallowing.
• Dietary and lifestyle changes can also be helpful in treating chronic aspiration.

The risk of pulmonary aspiration can be reduced in the following ways:

• Taking smaller bites and chewing slowly
• Avoiding eating and drinking while lying down
• Avoiding the foods that are difficult to chew
• Attending speech and occupational therapist
• Following proper instructions prior to surgery
• Avoiding foods for children that are easy to cause choking

Aspiration is a health condition as well as a medical procedure. The medical condition can be avoided by taking proper precautions or can be treated with a doctor’s advice and interventions. People with aspiration as a chronic health condition should take proper advice to avoid complications.