Silent Aspiration

[Atherton]

How can you tell when someone is silently aspirating?

Can silent aspeiration cause death much like drowning?

[Wulf]

Aspiration means that a substance, such as food or liquid, is going below the level of the vocal folds and potentially falling into your lungs when you swallow. When this happens, someone will typically start coughing, gagging, or choking because your body is sensing that something is "going down the wrong way". When you try to talk after swallowing, you may have a "gurgly" voice. Silent aspiration means that you are NOT displaying coughing, choking, etc. although you may have other symptoms, such as watery eyes or increased heart rate. Silent aspiration is a problem because just through observation, you may not be aware that it's happening. The way it is detected is during a procedure called a Modified Barium Swallow, or MBS. This is typically done at the hospital by a speech-language pathologist and a radiologist. An MBS is like an x-ray but it takes a moving picture of what's happening when you eat or drink something. The danger of any kind of aspiration is that food or liquid continually being taken into your lungs can cause aspiration pneumonia. There are all sorts of factors that determine your risk for pneumonia, such as level of activity, general health, etc., so it's not a 100% guarantee that you will get pneumonia. However, often as a precaution against getting pneumonia, which can be devastating in the elderly or weakened populations, the speech-language pathologist will recommend a modified diet. This may be thickening liquids, taking smaller bites/sips, not using a straw to drink, eating chopped or pureed foods, etc. So you won't drown, but pneumonia can lead to death, which is why medical personnel are cautious with swallowing issues.