My dad is elderly and has been in the hospital with pneumonia for a couple of days. The doctor suspected that it was aspiration pneumonia from eating. However, my dad had had a cold before he got very sick. The doctor ran a barium study which found the following:

Epiglottis normal without aspiration. Diminished motility without obstruction in esophagus, no hiatial hernia, however, there is mild gastroesophegael reflux. stomach, pyloris and duodenal bulb are unremarkable. impression: Diminished primary peristalsis is in esophagus, spontaneous reflux, otherwise unremarkable barium swallow.

The doctor is not allowing him to eat for fear of aspiration. Do the results of this study truly indicate that aspiration from food is a likely result from eating?
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replied May 1st, 2011
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caring4dad,

Aspiration can be caused by a combination of problems. Swallowing is actually a complex act. If there is a diminished physical capacity, along with a diminish mental capacity, swallowing can be very difficult.

The study is not horrible, but, there is a decrease in the esophagus's ability to move the food down on its own. Once you swallow, as the food goes past the larynx, it becomes the responsibility of the esophagus to push it on down to the stomach. There is a little bit a reflux, which on its own, probably would not be too much of a problem, except for heart burn. But, with decreased peristolsis, it may add to the problem.

Thus, if your dad is not too alert, he could have significant problems with swallowing, especially if his gag reflex is diminished. However, holding people without food for too long is not good either. Yes, nutrients can be given through the vein, but the gut has to be stimulated. It has been found in trauma patients, that when the gut is not stimulated with food, the bacteria in it can actually migrate out to the rest of the body. Hopefully, he is being fed through an NG tube, or he will be allowed to eat soon.

Hope your father feels better soon. Good luck.
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