Reflux is the movement of fluid and/or food from the stomach up into the esophagus. In the back of throat are the openings to the esophagus and the airway to the lungs called the trachea. When you breathe, this valve opens, allowing air into the trachea and lungs . When you eat, the epiglottis in the back of the throat closes so that food material does not pass into the trachea). Sometimes when you eat, liquids particularly, might “go down the wrong pipe,” and you start coughing. This process of liquid entering the trachea is called aspiration; coughing is the body’s way of clearing material from the trachea. The trachea and esophagus lie right next to each other. If reflux happens occasionally, it can travel all the way up the esophagus and enter the trachea, and that is also called aspiration.
The risk of aspiration is particularly increased at night when you are lying down and do not have the benefit of gravity helping to keep material in the stomach. Nighttime aspiration is common in those with reflux. The classic symptom is waking from sleep coughing, choking, wheezing, or tasting bitter material in your mouth. Most of the time this is scary and a nuisance, but if the liquid travels down to the lungs, you can have more serious problems, such as aspiration pneumonia. Aspiration pneumonia is a type of pneumonia (an infection of the lungs) caused by irritating acidic material entering and damaging the lungs. Sometimes you may need to take antibiotics to treat aspiration pneumonia; occasionally the condition can be very serious and require hospitalization. Chronic aspiration can also damage the trachea and lungs and make chronic lung disease or asthma worse.
There are ways to minimize the risk of nighttime reflux and aspiration. Avoid food for 2 hours prior to bed to allow the stomach to empty and to eliminate material to aspirate. Because there is no food or less food in the stomach, the pressure in the stomach is lower and the force promoting reflux is diminished. Elevating the head of the bed and sleeping on an incline can help use gravity to keep material down in the stomach. Special wedge-shaped pillows keep the head and chest above the level of the stomach. Antacid medications that will help with nighttime heartburn and aspiration can be taken at bedtime. Avoid certain foods and drinks —chocolate, caffeine from coffee or tea, and alcohol—at night or just before you sleep, because these relax the lower esophageal sphincter (the muscular valve at the bottom of the esophagus).
What is Aspiration? References
By Mortin - Copyright 2009
Last modification 31/12/2009