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What is aspiration?

Pulmonary aspiration is the medical term for a person accidentally inhaling an object or fluid into their windpipe and lungs. This can lead to coughing, difficulty breathing, discomfort, and sometimes choking.

Most people occasionally experience pulmonary aspiration when something they are eating or drinking “goes down the wrong way.”

Or, aspiration can be a continual problem that results from an underlying health condition.

The term aspiration can also refer to a medical procedure, during which a doctor uses a suction tube or needle to remove unwanted fluid from part of a person’s body.

In this article, we discuss the different meanings of aspiration and describe causes, risk factors, and complications. We also look into treatment and prevention strategies, how aspiration affects children, and when to see a doctor.

What is aspiration?

Aspiration has two health-related meanings. One is a medical condition, and the other is a procedure, so it is helpful to understand the difference.

Pulmonary aspiration

Woman coughing due to aspiration
Symptoms of aspiration can include coughing, wheezing, and painful swallowing.

Pulmonary aspiration is a condition that occurs when a person inhales a foreign substance into their windpipe and lungs.

It often happens when something a person is eating or drinking goes down the wrong way. Or, it can occur when someone breathes in:

  • water, such as when swimming or playing in a pool or river
  • saliva
  • stomach contents, including vomit
  • smoke, fumes, or dust

These substances can partially block the airways and irritate the lungs, which can lead to coughing, difficulty breathing, and other symptoms.

The aspiration procedure

Aspiration can also refer to a medical procedure, during which a healthcare professional uses a suction tube or needle to remove harmful fluid from the lungs, joints, abscesses, or other organs or tissues.

A doctor may also perform aspiration to take a sample of fluid and test it for signs of infection, cancer cells, or the presence of certain substances.

Symptoms

When a person aspirates something into their airways, it may not cause obvious symptoms.

However, if the substance even partially blocks the windpipe or irritates the lungs, it can lead to:

  • coughing
  • a feeling that something is stuck in the throat
  • painful swallowing
  • wheezing
  • trouble breathing
  • a hoarse voice

Causes

Usually when a person eats or drinks, the food or liquid moves from the mouth into the throat and down through the esophagus, or food pipe, into the stomach.

Pulmonary aspiration occurs when the substance accidentally passes into the windpipe and lungs instead of the esophagus. This typically results from a problem with the swallowing reflex or a lack of tongue control.

Aspiration can also occur while a person is having surgery under anesthesia. The stomach contents can travel up to the mouth, then down through the windpipe and into the lungs.

Anesthesia reduces a person’s level of consciousness and ability to protect their airways, which increases the risk of aspiration. This is why doctors often ask people to fast before having a surgical procedure.

Anesthetists also take precautions to prevent aspiration, such as by protecting the airways with intubation after administering anesthesia.

Some health conditions can also increase a person’s risk of pulmonary aspiration.

Risk factors

Most people occasionally aspirate something into their lungs, and certain issues can increase this risk.

A 2015 cross-sectional study investigated risk factors for aspiration in 105 people who had experienced at least one stroke.

The research indicated that participants with any of the following conditions were seven times more likely to develop aspiration:

  • dysphagia, which is the medical term for difficulty swallowing
  • an impaired or absent gag reflex
  • reduced physical mobility
  • neurological disorders, such as Parkinson’s disease

Additional factors that may increase a person’s risk of aspiration include:

  • intoxication from drugs or alcohol, which can lead to impaired consciousness and reflexes
  • dementia
  • gastroesophageal reflux disease (GERD)

Complications

man with fever temperature lying in bed looking at thermometer
Symptoms of aspiration pneumonia can include fatigue and fever.

Aspiration can introduce harmful foreign bodies or substances into the lungs, which can create additional problems.

For example, when a person aspirates something that contains harmful bacteria into the lungs, this can lead to infection and inflammation, which characterize a condition called aspiration pneumonia.

Symptoms of aspiration pneumonia can include:

  • a chronic cough
  • coughing up blood or green sputum
  • a fever
  • chest pain
  • fatigue
  • breathing difficulties, such as shortness of breath or wheezing

When aspiration involves toxic fumes, chemical pneumonia can develop.

Although there is no infection, chemical pneumonia causes inflammation and symptoms similar to those of aspiration pneumonia.

Aspiration in children

According to Children’s Hospital Colorado, aspiration is a common problem in children, and a parent or caregiver may not notice until the child chokes or develops a chronic cough.

A 2016 study reviewed the medical records of 102 children who underwent endoscopy after having symptoms of aspiration. The researchers found that 49 of these children had aspirated fragments of nuts or seeds.

Symptoms of aspiration in children may not be the same as those in adults and can include:

  • a grimacing expression
  • weak sucking
  • excessive drooling
  • feeding problems or difficulty breathing when feeding
  • wheezing
  • frequent chest infections

Risk factors for aspiration in children can include:

Treatment options for children with chronic aspiration can include GERD medications, speech or occupational therapy, and surgery.

When to see a doctor

Aspiration does not always require medical treatment. However, if any of the following symptoms arise, call 911 or go to the emergency room:

  • choking or a blocked airway
  • noisy breathing
  • bluish skin or nails
  • chest pain
  • wheezing

Symptoms of aspiration do not always present themselves immediately — they may take hours or days to develop.

See a doctor if the following symptoms occur after aspiration:

  • a fever
  • increased mucus production
  • chronic coughing
  • coughing up blood
  • foul-smelling mucus

Treatment

Treatment for aspiration depends on the severity of a person’s symptoms and the material they inhaled. In some instances, treatment is unnecessary.

If an object, such as a piece of food, is still in the lungs, the doctor may recommend a bronchoscopy.

During this procedure, a healthcare professional will insert a tube with a camera down a person’s throat and into the lungs to remove the foreign material.

For people aspiration pneumonia, a doctor may prescribe antibiotics to help clear the infection.

When aspiration results from a medical condition, such as a stroke, speech therapy may help to improve a person’s swallowing reflex and lower their risk of aspiration.

Dietary and lifestyle changes can also help treat chronic aspiration. If it fails to respond to these methods, a person may require tube-feeding to meet their nutritional needs.

Prevention

benefits of oatmeal
A person can take smaller bites of food and chew slowly to reduce the risk of pulmonary aspiration.

A person can take steps to reduce their risk of pulmonary aspiration, including:

  • taking smaller bites of food and chewing slowly
  • avoiding foods that are difficult to chew, such as fatty cuts of meat
  • refraining from eating or drinking while lying down
  • avoiding giving children foods that are easy to choke on, such as nuts, seeds, hotdogs, and grapes
  • attending speech or occupational therapy to improve swallowing techniques
  • following the doctor’s instructions for fasting prior to surgery
  • speaking with a doctor about medications that affect swallowing

Summary

Aspiration can refer to a health condition or medical procedure.

During the procedure, a doctor uses a suction tube or needle to remove fluid from part of a person’s body.

The health condition, called pulmonary aspiration, happens when a person accidentally inhales a foreign substance, such as food or drink, into their lungs.

Symptoms can vary in severity, but people are often able to cough up the inhaled material.

Inhaling harmful substances can lead to complications such as pneumonia. Certain medical conditions, including dysphagia and GERD, can increase a person’s risk of aspiration.

Mild aspiration does not usually require treatment. However, see a doctor if the foreign material becomes stuck in the lungs, or symptoms of pneumonia develop.

For people with chronic aspiration, the doctor will focus on treating the underlying cause. Also, speech therapy can help improve a person’s swallowing technique and tongue control.

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