Hi lori,

Sorry to bug you again, I have tried looking it up on the internet and couldn't get anywhere, so I thought I would pick your brains. I hope this makes sense.

With aspiration, does the result always end up with pneumonia?

I am wondering if Parker aspirates, he gets a lot of chest infections, and last year, this is how it would go, he would have a cold/cough for a week, I would take him to a doctor, they would say it was viral, then a week later we go back and they would say oh still a chest infection, here is keflex, then two weeks later I would be back again cause it didn't do anything, and the doctor would say oh it is probably micoplasma pneumonia, here is either erythromycin or zithromax, both these drugs generally work well with him when he has chesty things going on. This happenned once this year, twice last year, and once the year before.

So I am wondering these aren't definate pneumonias cause no x ray at the time of diagnosing, but the respiratory physician thinks it could be, the GP is sure. Can aspiration cause these types of pneumonias? Can it cause other problems like a standard chest infection without pneumonia, does it always need abx to clear it up?

I know he refluxes up into his nose, since decreasing his meds he has started rubbing his nose after a cough and last night he was going ow, ow, ow and rubbing his nose after a cough, so I think it is raw in there.

Also if we have a bronchioscope and he has aspirated in the past and isn't now, would they still be able to see the damage? Are there other tests he can have to see if he is or has aspirated?

Thanks Lori, I hope that made sense!

I have to say Scarlet, he does sound exactly like Kitty :-( She refluxes down her nose too, and chokes really badly sometimes when she refluxes. She has not had pneumonia thank goodness but plenty of chest infections. Your reply to my post sounds very like Kitty too. Aspiration means stuff from the oesophagus being sucked into the trachea and lungs. It is a mechanical process, the name doesn't imply that pneumonia always results. I have done it twice, once when pg with the twins but I am a tough old bird it would seem and nothing untoward happened. It is the main reason for us going for the fundo tbh. They are talking about a scope for me now too - but I made my mild reflux a whole lot worse with eating disorders years ago, hence my research!

Kate x

Rachel, chest "infection" implies pneumonia, whether it is viral or bacterial. Aspiration can certainly cause a pneumonia if whatever is aspirated causes bacteria to grow uncontrolled. Aspiration may also cause pneumonitis, which is inflammation of the lung mucosa. GI contents are highly acidic (less so if on PPIs of course) and can cause damage to the mucosa. This can be long or short term depending on the exposure. Long term pneumonitis can lead to fibrosis of lung tissue. Fibrosis can be a lifelong issue and could definitely be seen long after the aspiration event. However, keep in mind that this is worst case scenario, and I would not expect to see it in Parker.

I hope I answered your question. It has been a long weekend at work, and I am afraid I might be talking in circles.

Rachel, chest "infection" implies pneumonia, whether it is viral or bacterial. Aspiration can certainly cause a pneumonia if whatever is aspirated causes bacteria to grow uncontrolled. Aspiration may also cause pneumonitis, which is inflammation of the lung mucosa. GI contents are highly acidic (less so if on PPIs of course) and can cause damage to the mucosa. This can be long or short term depending on the exposure. Long term pneumonitis can lead to fibrosis of lung tissue. Fibrosis can be a lifelong issue and could definitely be seen long after the aspiration event. However, keep in mind that this is worst case scenario, and I would not expect to see it in Parker.

I hope I answered your question. It has been a long weekend at work, and I am afraid I might be talking in circles.

So basically all the chest infections could have been caused by aspiration? Well then I am not sure now cause I am pretty sure that they have been caused by colds that then turn nasty KWIM? Cause generally it is cause Cooper has bought something to the house, but then he could have the cold, reflux more and thus causing the chest infection...interesting.

So would a bronchioscope be the only way to diagnose it? And would it show scarring or inflammation even if his last bad bought of resp infections was over 6 months ago?

I am sorry you are having such a tough time at work, I have heard that it is a pretty bad winter for resp. problems, weird cause our last winter was a really bad one too, it must have travelled.