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Aspiration Pneumonia

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Correlation with Lung Involvement
Diagnosis
Prevention
Personal Stories

Overview of Aspiration Pneumonia

Aspiration pneumonia occurs when vomitus or reflux gets into the lungs, causing an often deadly form of pneumonia. Anyone (with or without scleroderma) can get aspiration pneumonia. It often occurs in systemic scleroderma patients due to esophagus problems.
Aspiration pneumonia is caused by breathing foreign materials (usually food, liquids, vomitvomit, or fluids from the mouth) into the lungs. This may lead to a collection of pus in the lungs (lung abscess); an inflammatory reaction; or a lung infection (pneumoniapneumonia). Medline Plus.
Shortness of Breath This worrisome symptom has many acute and chronic causes. Follow this flowchart for more information about the diseases in which shortness of breath occurs. familydoctor.org
Does Chronic Microaspiration Cause Idiopathic Pulmonary Fibrosis? Emerging data support a role for chronic microaspiration (i.e., subclinical aspiration of small droplets) in the pathogenesis and natural history of idiopathic pulmonary fibrosis. However, the precise relationship between chronic microaspiration and idiopathic pulmonary fibrosis remains unknown. Joyce S. Lee, MD Volume 123, Issue 4, Pages 304-311 (April 2010). (Also see: Pulmonary Fibrosis)

Correlation with Esophageal and Lung Involvement

People with systemic scleroderma are very likely to have chronic heartburn, and uncontrolled heartburn might be a cause of pulmonary (lung) fibrosis. Also, people with heartburn have a greater risk of aspiration pneumonia. (Also see: What is Scleroderma? and Heartburn/Reflux)
Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients. Patients with IPF have risk or definite pulmonary aspiration of gastric contents. Eur Respir J. 2013 Mar 7. (Also see: Heartburn/Reflux)

Diagnosis of Aspiration Pneumonia

Symptoms include cough, coughing up sputum, and sometimes fever. The pneumonia will usually show up on chest x-ray, but a sputum culture will show that the pneumonia isn't caused by bacteria. Aspiration pneumonia should be suspected if a scleroderma patient has recurrent pneumonia. An estimated 30-50% of cases lead to death. However, mild cases may cause no symptoms at all.

Prevention of Aspiration Pneumonia

Preventive measures include carefully following your doctor's instructions for dealing with reflux (heartburn), such as taking medicines, elevating the head of the bed, and not eating near bedtime.

If you are instructed to elevate the head of your bed with bricks (a standard recommendation for reflux), do exactly that. Do not sleep sitting up, or propped up by several pillows, as this can worsen the problem by putting pressure on your stomach, thereby increasing the risk of aspiration pneumonia. (Also See: Reflux)

Personal Stories about Aspiration Pneumonia

Bree: My Father Died from Aspiration Pneumonia I do not fully understand how or why this form of disease would cause a person to die...
Daphne: Daughter of Scleroderma/Polymyositis/Antisynthetase Syndrome Overlap Patient By early 2005, she began to exhibit Raynaud's phenomenon. She was also having swelling in her face, hands and feet...
 
Go to Diagnosis of Scleroderma Lung Involvement
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