What does “aspiration” mean?

ALS can cause weakness or spasticity in the muscles of the tongue, pharynx, or larynx. This results in difficulty swallowing and the entry of foreign substances (saliva, liquids, or food particles) into the airways. The unintended inhalation of foreign substances into the trachea and bronchial system is referred to as “aspiration.” Aspiration can be very distressing and trigger a cough reflex. In other situations, aspiration may go unnoticed, especially when the amount swallowed is small (“silent aspiration”).

Preventing aspiration is a key goal of speech-language therapy, which includes swallowing exercises. The focus of these exercises is on improving the coordination between breathing and swallowing. Other measures to reduce aspiration include nutritional therapy (ranging from dietary modifications and avoiding certain food components to the use of supplemental liquid nutrition or a feeding tube) as well as medication to reduce saliva production.

Preventing aspiration is important because swallowing food particles can lead to acute narrowing of the airways (obstruction) or pneumonia.