O7.4 Aspiration

Aspiration of food and liquid is common in COPD and may be the cause of recurrent exacerbations and complications, such as pneumonia and patchy pulmonary fibrosis. Some patients with COPD experience disrupted breathing-swallowing co-ordination and may be at risk of aspiration which may also contribute to exacerbations. (Gross et al., 2009)

Diagnosis is usually easy with an adequate history from patients and their partners or carers. Dry biscuits and thin fluids cause the most difficulty. Confirmation rests with assessment by a speech therapist/ pathologist and videofluoroscopy.

Treatment involves retraining in safe swallowing tech­niques, which may include:

• avoiding talking when eating;
• sitting upright;
• taking small mouthfuls;
• chewing adequately;
• drinking with dry foods;
• using a straw; and
• drinking thickened fluids.