Aspiration pneumonia: Causes, symptoms, diagnosis, treatment and prevention

Aspiration pneumonia is essentially a kind of bacterial pneumonia that is caused by regurgitation of foods into your bronchus that is supposed to be swallowed into your stomach. It predominantly affects old patients with impaired gag reflex, such as those with a brain stroke. It is treated with antibiotics, similarly to that of bacterial pneumonia. Prevention is in fact more important than treating this condition.

Causes

In healthy individuals, the food we chew will go to the esophagus and stomach. Once the chewed food incidentally goes into the bronchus, then you will experience a gag reflex that helps you to gag the food out of the bronchus. However, when one’s gag reflex is compromised, such as one who had a brain stroke, then he or she does not feel the food when it is aspirated into the bronchus with resultant inability to stimulate a gag reflex. Once the foods, which obviously are contaminated with too many bacteria, are aspirated into the bronchus, the bacteria in the food would cause lung inflammation. This is how aspiration pneumonia occur. Aspiration pneumonia predominantly affect:

  • Patients with reduced consciousness or with dementia;
  • Patients with stroke or seizures;
  • Patients with esophageal disorders, such as gastrointestinal reflux disease;

Symptoms

Common symtpoms of aspiration pneumonia include:

  • Trouble swallowing
  • Fever and chills
  • Bluish discoloration of mouth and fingertips
  • Sputum that may even contain undigested food
  • Rapid heart beats
  • Confusion and changes in mental status
  • Wheezing or shortness of breath

Diagnosis

Your doctor would suspect aspiration pneumonia if you have swallowing problems and clinical symptoms of pneumonia. If undigested food is found in the sputum, this confirms aspiration pneumonia. Your doctor also need to do additional tests:

  • Blood tests to see if you have body inflammation, such as C-reactive protein, procalcitonin (PCT), and a complete blood count.
  • Chest X-ray or CT scans to evaluate the presence, extent and severity of the pneumonia.
  • Sputum culture: similar to bacterial pneumonia, your doctor may collect your sputum samples to determine which kind of bacteria is causing your pneumonia.
  • Bronchoscopy in selected cases. This procedure inserts a thin tube to your bronchus through your mouth and can directly see your lung. It can directly visualize the undigested food and effectively retrieve the food.

Treatment

The treatment for aspiration pneumonia is similar to that of bacterial pneumonia. Oxygen inhalation and use of medications to lower the body temperature may be considered. Antibiotics is the main treatment for aspiration pneumonia.

Prevention

Prevention is much more important than treatment for aspiration pneumonia. For patients with difficulty swallowing, being careful and nursing are important.

Sit up while eating: This can effectively reduce the risk of aspiration.

Eat soft foods or liquid foods: These foods can be more easily swallowed than solid foods.

Care your mouth with regular oral hygiene measures, such as brushing and cleansing.

If the patient is in high risk for aspiration, a gastric tube can be inserted into the stomach through the nose. The carer can inject liquid food to the stomach, whereas the patient does not need to swallow foods. This can also reduce the risk of aspiration pneumonia.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.