Silent Aspiration: A Silent But Potentially Deadly Condition

• Almost 30% of pneumonia deaths in those over the age of 60 can be attributed to silent aspiration.
• The invisible symptoms of silent aspiration pose a grave danger as neither patients nor their caregivers are aware that food or liquids have entered their respiratory system. One of the most serious complications that can arise from such an occurrence is a life-threatening disorder known as aspiration pneumonia.  
• Should elderly patients develop a fever, cough up phlegm, have difficulty breathing, lose their breath easily, experience a tightness in the chest, or become withdrawn, it could be a sign that they are at risk of bronchitis or pneumonia. In such cases, they should not be allowed to eat and be taken to seek medical treatment immediately.

Silent aspiration refers to swallowing food or liquids into the respiratory system without any obvious symptoms of coughing or a wet voice. It is a condition most common among patients with swallowing difficulties. The disorder is capable of affecting anyone of any age or gender.

Between 40–70% of elderly patients who suffer from neurological disorders, such as stroke, Parkinson’s disease, or Dementia, have been found to experience silent aspiration, while their risk of experiencing swallowing issues is as high as 50–75%. Moreover, up to 71% of elderly patients suffer from pneumonia because of silent aspiration, with almost 30% of pneumonia deaths in those over the age of 60 attributed to silent aspiration.

The fact that the symptoms of silent aspiration are invisible to both patients and their caregivers means this condition poses a grave danger as there is no way of knowing whether food or liquids have entered their respiratory system. One of the most serious complications that can arise from such an occurrence is aspiration pneumonia, which is a life-threatening disorder.  
Unfortunately, even physical examinations carried out in clinics may be unable to detect the condition due to signs being impossible to pick up using regular health screening techniques. Hence, screening should be undertaken by doctors specializing in this area. These specialist doctors will carry out a barium swallow test or esophagram to check whether silent aspiration has occurred and to assess whether they should undertake preventive measures or treatment.
 
Patients experiencing bronchitis or pneumonia resulting from silent aspiration may display the following symptoms:

• A fever alongside a phlegmy cough
• Difficulties breathing or losing breath easily
• Tightening and pain in the chest
• Becoming withdrawn

Should such symptoms become apparent, caregivers should ensure the patient ceases eating and is taken to seek medical treatment immediately.

• They seem to have difficulty swallowing their saliva or are salivating all the time.
• There is food present on the inside of their mouth.
• They may complain of having “something in my throat” and feel a lump in their esophagus.
• They need multiple attempts to swallow anything.
• They cough, or choke when they eat or drink.
• They regurgitate food and liquid while eating and drinking.
• They lose weight due to a loss of appetite.

Once a patient has been diagnosed as suffering with swallowing difficulties by doctors specializing in that field, they will be given treatment based on their specific issue to prevent them choking on foods and liquids. Such treatment may include adjusting the type of food they are given, modifying their posture, changing the way they are fed, adjusting the amount of food and water they are given each day, improving their oral hygiene, and undertaking training aimed at improving their swallowing capabilities.

Seek a medical consultation should you notice swallowing irregularities alongside the following issues in an elderly patient:

• Problems chewing or swallowing (regardless of whether it is accompanied by coughing)
• Pneumonia, especially repeat infections
• Neurological disorders
• Head and neck cancer