Aspiration can be roughly defined as a situation when something that a person swallows enters the lungs or airway. It can also take place when something from the stomach of a person goes back into his throat. But unlike choking, the airway is not blocked completely.
A person who aspirates often or mostly tends to have problem swallowing; it also includes people who have had a stroke, who are older, or who have developmental disabilities.
What Does Aspiration Mean?
Many people tend to experience pulmonary aspiration occasionally when something that is being eaten or drunk by them ends up going down the wrong way. Alternatively, the term aspiration is also used for a continual problem as a result of an underlying condition affecting the health of a person. It is also referred to as a medical procedure in the process of which a doctor makes use of a needle or suction tube for the effective removal of unwanted fluid from a part of the body of a person.
Any person can aspirate. The content inhaled by them is generally coughed up by most people. But a person suffering from an underlying condition tends to be at a higher risk for aspiration ending up into something that is much more serious. The outlook for aspiration generally depends on the cause. For several people, eating techniques and swallowing therapy, for instance, pureeing a solid food item, softening, or chopping can help in the efficient prevention of aspiration.
This article aims to discuss the different meaning that is associated with the word “aspiration” along with describing the causes, complications, risk factors, and other essential points coupled with it; say, for instance, strategies to prevent aspiration, how aspiration affect children when to consider visiting a doctor, etc. Continue reading to know more.
Aspiration is generally conducted with two meanings related to health. One of them is a medical condition, while the other one is a procedure. A person must be well-aware of the difference between the two.
Pulmonary Aspiration
Pulmonary aspiration is known as a condition that tends to occur when a person ends up inhaling a foreign substance into his lungs and windpipe. It generally happens when something being eaten or drunk by a person ends up going down the wrong way. Apart from this, it can also occur when a person breathes in:
- Saliva
- Dust, smoke, or fumes
- Water, such as when he is playing or swimming in a river or a pool
- Stomach contents, for instance, vomiting
The substances mentioned above can block the airways partially while irritating the lungs of a person. This can lead to difficulty in breathing, coughing, or any other such symptoms.
The Aspiration Procedure
Aspiration can also be referred to as a medical procedure, during which a healthcare professional makes use of a needle or suction tube the removal of any harmful fluid present in the lungs, abscesses, tissues, joints, or other organs of the body.
A doctor might also consider performing aspiration by taking a sample of fluid and testing it for any sign of cancer cells, infection, or the presence of a particular substance.
It is the extraction of fluids via a needle, syringe, or any other device used for suctioning. The medical technique is considered to solve dual purposes. It might be used for the removal of harmful or excessive fluids from the body of a person. The aspirated fluid is therefore sent to a laboratory for further analysis.
Aspiration for Treatment
There tend to exist several reasons as a result of which fluids might get build up inside the body of a person. If such a situation happens, small amounts of the fluid can be drawn off, as provided above, with the use of a syringe and a needle.
A thicker or larger amount of liquid might be required to get drained within a particular period with the assistance of a thin plastic tube. Aspiration may be needed for the treatment of a medical condition. This has been elucidated as follows:
Infection
As the body of a person fights off any infection, the dead white blood cells end up combining with the fluids present in the body along with other dead cells to form what is called pus. This can collect in the infected area and might require to be drained to get relief against pain and further help in effective treatment. One such example is the draining of an abscess.
Hemorrhage and Effusion
There are times when other fluids might accumulate inside the body of a person and cause various problems. For instance, a pleural effusion in which the fluids present in the body end up building in the spaces between the chest wall and the lining of the lungs. Another example can be an internal hemorrhage where the blood present in the body can get collected inside the abdomen or any other organ.
Joint Swelling
The joints might get swollen sometimes as a result of the excessive presence of synovial fluid. You must be wondering what synovial fluid is! It is a viscous substance that helps in the lubrication of a joint space. After any inflammation condition or injury, this fluid can end up building to an excessive amount and group with other fluids present in the body which are released at the time of inflammation. When fluids are extracted from a joint space, it is known as arthrocentesis.
Arthritis
People suffering from arthritis and any other conditions that affect the mobility of joints might benefit when lubricating fluids are injected into the joint space, for instance, hyaluronic acid. Before this, the fluid might be required to get extracted to leave room for the fluids that are injected into the area.
Airway Clearance
A suctioning device might be required to ensure that the airways are clear in a person suffering from a condition called a tracheostomy. This is characterized by the insertion of a breathing tube into the windpipe through the neck.
Abortion
Vacuum aspiration as a technique is sometimes used at the time of early adoption, usually when a woman is between weeks 5 and 12 of the gestation period.
Aspiration for Diagnosis
The draining of fluids of the body, whether in tandem with treatment or on its own, can help provide a doctor with a means to identify the cause behind any disease. These may comprise procedures like fine needle aspiration (FNA) with the use of a lower gauge needle, and core needle biopsy (CNB) with the use of a larger gauge needle for extracting cells, fluids, and tissues.
Some of the conditions where aspiration might be used for diagnosis are:
- Identification of a tumor for the presence of cancer cells
- Culturing of the fluid for the identification of fungi or bacterial stains
- Staining of the fluid for the identification of the types of bacteria under a microscope
- Examination of the fluid for evidence of crystals (for instance, occurrence with pseudogout or gout)
- Extraction of placental tissue or amniotic fluids at the time of pregnancy to screen for any congenital disease
What Happens When A Person Aspirates?
Aspiration, as mentioned above, is the inhalation of some type of foreign substance or object into the airway of a person. Usually, it is the contents of the stomach, food, or saliva that tends to make their way into the lungs when a person experiences heartburn, swallows, or vomits. Aspiration is generally more prevalent in infants, people who are intubated, older adults, and people who tend to face trouble controlling their tongues or while swallowing.
There are times when aspiration might not cause any symptoms. This is referred to as “silent aspiration.” A person might experience a sudden cough as his lungs try to clear out any substance. Some people might wheeze, have a hoarse voice after eating, vomiting, or drinking, have trouble breathing, or experience heartburn. If such a situation starts occurring frequently, a person might have chronic aspiration.
There are times when aspiration fails to cause any complications. Many times, however, it can result in serious issues such as aspiration pneumonia (a situation where the lungs get affected). If a person suspects aspiration in himself or any other person he cares for, he should always consider visiting his doctor.
Aspiration At The Time Of A Surgery
While a person is under sedation or general anesthesia, contents present in his stomach might end up moving upwards to his mouth and enter his lungs and trachea. A surgical team is well-prepared for a moment like this, but it must be kept in mind that this is the reason why fasting before surgery is important. Drooling post-surgery might be a symptom of aspiration.
A study conducted in New Zealand and Australia in 2019 discovered that a patient over the age of 80 and an emergency procedure are two of the biggest factors or risks for aspiration at the time of surgery.
Symptoms relating to Aspiration
When a person ends up aspirating something into his airways, it might not lead to causing any obvious symptoms. However, if such a substance irritates the lungs or ends up blocking the windpipe partially, it can cause several symptoms.
Sometimes there does not exist any clear sign that liquid or food is going down the incorrect way. Because a person fails to notice it, he does not cough. But in most situations, he might experience one or some of the following symptoms:
- Pain while swallowing
- A feeling of something being stuck in the throat
- Hard to swallow or hurts when done
- Cough after or while a person drinks or eats
- Hoarse voice
- Trouble while breathing
- Wheezing
- Feeling congested after drinking or eating
- Having a wet-sounding or gurgling voice while eating
Other signs include:
- Lot of saliva in the mouth
- Heartburn or chest discomfort
- Fatigue or shortness of breath while eating
- Fever immediately half an hour after eating
- Frequent pneumonia
- Trouble chewing
Causes of Aspiration
Pulmonary aspiration tends to occur when a substance passed into the lungs and windpipe accidentally instead of the food pipe.
It can also take place when a person is undergoing surgery under anesthesia. Anesthesia is known to reduce the level of consciousness of a person along with the ability to protect the airways; this ends up increasing the risk of aspiration. Because of this reason, a doctor generally asks a person to fast before undergoing a surgical procedure.
Anesthetists also take additional precautions for the prevention of aspiration, such as the protection of airways after the administration of anesthesia with the help of intubation.
The chances of aspiration tend to rise with age as a person might end up with troubles associated with swallowing and chewing.
Other things that can cause aspiration are:
- Seizures
- Acid reflux
- Loss of muscle tone or coordination interfering with how effectively a person chews or swallows
- Throat cancer
- Stroke
- Drinking or eating fast
- Mouth sores
- Frequent vomiting
- Fatigue
- Loss of mental ability
- Reaction as a result of medication
- Neck and head injuries
- Nervous system disorders such as Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS)
- Dental problems
- Chemotherapy for neck or throat or radiation
- Feeding tubes or breathing machines
Many people refer to a case concerning aspiration as food not going the right way. This can end up happening as a result of reduced control of the tongue, medical devices assisting breathing, or poor swallowing reflexes.
An average person can generally cough out any foreign object before it gets into the lungs. Aspiration, most often, can be the result of the following causes:
- Neuromuscular causes
- Oesophageal disorders
- Throat surgery
- Dental problems
- A medical device in the airway
Aspiration in Children
A few children tend to have trouble swallowing as a result of throat muscle problems caused by:
- Physical conditions like cleft palate
- Brain damage
- Muscle diseases such as spinal muscular atrophy
- Delayed rate of growth
- Nerve problems
Certain common symptoms of aspiration in children and babies include:
- Weak sucking
- Breathing that stops or speeds up while feeding
- Breathing problems such as wheezing
- Watery eyes, grimacing while feeding, or red face
- Little fever after feeding
- Infections in the airway or lung frequently
Aspiration in Older Adults
Older adults are more likely to suffer from a condition called Dysphagia, a difficulty in swallowing. It is very common among adults suffering from multiple sclerosis, dementia, GERD, Parkinson’s disease, any other neuromuscular condition, or stroke patient. Aspiration is considered one of the symptoms of Dysphagia. Older adults who tend to require a feeding tube are also known to be at a high risk of aspiration.
Diagnosis of Aspiration
A doctor of a person generally tends to ask him about his symptoms, which is followed by a physical exam. He might additionally take a close look at his cheeks or mouth. Additionally, he might also recommend a person to visit a specialist known as a speech-language pathologist; he can check for any existing issues with his swallowing muscles.
He might have tests such as:
X-rays
These can help provide the doctor with an image of the quantity of material breathed in by the person.
Bronchoscopy
A doctor gives a person to make him feel relaxed and puts a thin tube known as a bronchoscope inside his throat. It is coupled with a tiny camera for taking images of the insides of his lungs.
Modified Barium Swallow (MBS)
A technician takes an X-ray of the food pipe and throat while a person swallows liquids and foods mixed with a chemical known as barium.
Pharyngeal Manometry
By numbing the nose of a person, a technician puts a tube known as a catheter into his throat and through the nose. This tube has sensors for effectively measuring the pressure in the food pipe and the throat when a person swallows.
Fiber-Optic Endoscopic Evaluation of Swallowing (FEES)
A specialist numbs the nose of a person. He then puts a flexible and thin tube known as an endoscope into his throat and through his nose. A camera on the tube clicks pictures while a person swallows liquids, saliva, and food.
Complications associated with Aspiration
Aspiration can result in various severe issues such as damage to tissue or infection. For instance, aspiration pneumonia is a lung infection known to cause inflammation coupled with a buildup of fluid. The symptoms might turn in slowly. Without any treatment, such symptoms might become dangerous. With time, aspiration can also lead to weight loss, dehydration, malnutrition, and an increase in catching any other illness.
Aspiration can introduce harmful foreign substances or bodies into the lungs; this can end up creating additional problems. For instance, when a person aspirates something into his lungs, this can lead to inflammation and infection. This is characterized by a condition known as aspiration pneumonia.
Some symptoms of aspiration pneumonia are as follows:
- A chronic cough
- A fever
- Fatigue
- Coughing up green sputum or blood
- Chest pain
- Breathing difficulties such as wheezing or shortness of breath
When aspiration tends to involve toxic fumes, it can result in the development of chemical pneumonia. Although there fails to exist any infection, chemical pneumonia tends to cause inflammation and symptoms which are similar to those associated with aspiration pneumonia.
Prevention of Aspiration
A person can take several steps when it comes to reducing the risks associated with pulmonary aspiration. Such preventive steps include:
- Taking small bites of food and chewing at a slow pace
- Avoiding the consumption of food items that are difficult to chew, like the fatty cut of meat
- Refraining from drinking or eating while lying down
- Avoiding feeding a child food that is easy to choke on, for instance, seeds, grapes, nuts, and hotdogs
- Attending occupational or speech therapy for improving swallowing techniques
- Following the instructions of the doctor for fasting before a surgery
- Visiting a doctor and speaking to him about medications that might affect swallowing
A person can consider trying the following tips to avoid aspiration when he swallows:
- Eat only when he is relaxed and alert
- Cut his food into smaller pieces
- Always consider swallowing before he takes the next bite
- Avoiding food items that stick together
- Refrain from talking while he is drinking or eating
- Refrain from drinking or eating while lying flat
- Sit in a food posture while eating
- Take care of his teeth and mouth (visit a dentist regularly)
- Avoid smoking
When Should You Visit A Doctor?
Aspiration might not always need medical treatment. However, if any of the symptoms mentioned below end up arising, a person should consider calling 911 or visiting an emergency room:
- A blocked airway or choking
- Noisy breathing
- Bluish nails or skin
- Chest pain
- Wheezing
Symptoms associated with aspiration do not always show their presence immediately, but might take a few hours or days to completely develop. A person should additionally visit a doctor if the symptoms mentioned below occur post aspiration:
- Fever
- Chronic coughing
- Foul-smelling mucus
- Increased production of mucus
- Coughing up blood
Treatment of Aspiration
The treatment of aspiration depends on the severity of the symptoms a person faces and the material inhaled by him. In several instances, treatment is not necessary.
If any object like a piece of food is still present in the lungs, a doctor might consider recommending a bronchoscopy. During this procedure, healthcare professionals insert a tube along with a tube with a camera down the throat of a person and into the lungs for the removal of any foreign material.
For people down with aspiration pneumonia, a doctor might consider prescribing antibiotics for clearing their infection.
When aspiration comes as a result of a medical condition such as a stroke, speech therapy might help a person improve his swallowing reflex and lower any risk of aspiration. Lifestyle and dietary changes can also assist in the treatment of chronic aspiration. If it fails to respond to such methods, a person might need tube feeding for meeting the nutritional requirements.
Conclusion
Aspiration can be referred to as a medical procedure or a health condition. At the time of the procedure, a doctor uses a needle or a suction tube for removing fluid present in the body of a person. Pulmonary aspiration is a health condition that takes place when a person accidentally ends up inhaling a foreign substance, such as a drink or food, into the lungs.
Symptoms can differ in severity, but people are generally able to cough up the material inhaled. Inhaling any harmful substances might lead to complications like pneumonia. Several medical conditions, such as GERD or dysphagia, can lead to an increase in the risk of aspiration.
Aspiration at a mild level does not generally require any treatment. However, a person should consider visiting a doctor if any foreign material gets stuck in his lungs, or if he witnesses the development of pneumonia.
For a person with chronic aspiration, a doctor will consider focusing on the treatment of an underlying cause. Also, speech therapy can help in the improvement of the swallowing technique of a person and control of the tongue.
