Causes And Risk Factors For Aspiration

Aspiration is a term utilized to characterize when an individual breathes foreign objects into the airways that feed into their lungs. The most common objects that cause aspiration include food, saliva, and stomach contents from vomiting, heartburn, and swallowing. Many individuals describe aspiration as when food goes down the wrong way. Aspiration that occurs in a healthy individual occasionally does not cause a problem because they can cough and expel the object before it gets into their lungs.

The most common individuals affected by chronic and frequent aspiration that can cause serious complications are the elderly population and infants. Aspiration may also occur when patients are under anesthesia and the contents of their stomach enter their trachea and lungs. Chronic aspiration produces symptoms like wheezing, coughing, and a hoarse voice after they drink, eat, experience heartburn, or vomit.

Parkinson's Disease

Parkinson's disease is a progressive and irreversible disorder of the nervous system where an individual slowly loses function and movement in their body. Individuals affected by Parkinson's disease have neurons or nerve cells in their brains that die or slowly break down over time. The lack of functional neurons in the brain causes patients to have a lower than normal amount of dopamine in their brain.

Low dopamine keeps electrical impulses from moving from nerve to nerve properly. This abnormal activity in an affected individual's brain causes them to experience symptoms like tremors, rigid muscles, impaired posture, poor balance, loss of automatic movements, writing changes, changes in speech, and slowed movement. When a Parkinson's disease patient has problems with swallowing, they can experience aspiration as a result of their impaired ability to move food down their esophagus instead of into their windpipe.

Dysphagia

An individual who experiences dysphagia may also be affected by aspiration due to their impaired ability to swallow food and liquid effectively. Dysphagia is the medical term utilized to describe when an individual is unable to swallow at all or has a limited ability to move food or liquid into their esophagus without it moving into their lungs. An individual affected by dysphagia will experience symptoms like coughing, choking, a sensation that food is stuck in the throat, persistent drooling, and food coming up through the nose.

Dysphagia can occur due to stroke, dementia, head injury, esophageal cancer, mouth cancer, gastroesophageal reflux disease, learning disability, developmental disability, and several other medical conditions. The epiglottis is the flap or membrane of tissue that moves over the opening of the windpipe when an individual swallows food. Problems with swallowing can cause food to move into an individual's windpipe instead of their esophagus because the epiglottis does not coordinate properly in the process of swallowing, which causes aspiration.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease is a disorder of the digestive system that causes stomach acid to flow back up into the esophagus. The backwash of stomach acid that enters an affected individual's esophagus causes inflammation and damage to the esophageal tissues. Acid reflux is the backwash of acid into the esophagus, and gastroesophageal reflux disease describes episodes of acid reflux that occur at least twice per week in an individual.

The inflammation that occurs in the esophagus of a gastroesophageal reflux disease patient causes its tissues to become swollen and the inner esophageal tube to become more narrow than usual. An individual who has a swollen and narrowed esophagus is more likely to experience aspiration because food can be redirected into the windpipe easier.

Dental Issues

The risk of foreign body aspiration has long been recognized in the dental community, as this kind of aspiration occurs due to dental appliances, dental fixtures, dental instruments, and other dental equipment coming loose in the mouth or falling into the patient's throat during a dental procedure. Individuals who tend to have poor oral hygiene are also at an increased risk of experiencing aspiration.

Decaying teeth tend to attract food particles that harden into plaque and tartar on the teeth, which can be aspirated if it is allowed to accumulate. Extreme tooth decay can cause an individual to lose chunks or pieces of a tooth, which can also be aspirated down their windpipe and into their lungs. Dental issues can also cause problems with swallowing, which can also cause them to aspirate food particles or other matter into their lungs.

Throat Surgery

An individual who undergoes certain surgical procedures performed on their throat or neck may experience post-surgical aspiration. There are numerous reasons for an individual to undergo surgery on their neck and throat, including the removal of the tonsils, benign or malignant growth removal, cyst removal, thyroid gland removal, repair of a fissure in the esophagus, and procedures to correct structural abnormalities in the throat and neck.

An individual who has surgery on their neck and throat can experience traumatic damage to the nerves and muscles in this region. Damage to the nerves or muscles on a temporary or permanent basis due to a surgical procedure can cause problems with the carefully coordinated process required for individuals to be able to swallow properly. An individual who cannot swallow correctly due to a prior surgical procedure can experience aspiration of food and particles into their lungs.