Other Causes to Look For-Aspiration

[CrabbyRoad]

My Dad within the last month age 77- was taken to the hospital for pneumonia, after a bout of bronchitis, he was getting weak and very off balance and falling. They put in a feeding tube during the time of recovery, as he need to be put on a breathing machine to assist (not full life support). When that bout was over, he was sent to a Rehabilitation Hospital, he was over fed his first meal, and to my understanding, not the appropriate foods to begin with, and that night, he was rushed back to ER as he struggled to breathe, and found the food had aspirated in his lungs while he was asleep. Few days later, after the contents were clear of lungs, (had xrays, stress test-due to shortness of breath prior to hospitalization, barium swallow test, full GI-every thing was clear), again back to the Rehabilitation Hospital for swallowing therapy-was doing well for past two weeks, until night before last while sleeping, he aspirated again, sending him back to the ER. He went for more tests, as they again are clearing out the gastric contents in his lungs. Tests indicated today, his esophagus is retaining food? And also that the flap near the throat swallowing muscle is also retaining some of the fluids he drinks- was told he can't have thin liquids like water, only textured drinks. What are causes of and treatment or surgery on the esophagus that is retaining the food content? Same for the flap? We are just scared that if and when he comes home, that someone will need to be awake 24/7 to make sure he doesn't start aspirating again, seems like textured drinks would still be retained just as much as thin liquids. Our heads and the doctors heads are just spinning and at a loss as to explain, how or what is causing this. Thank you in advance.      

[National Jewish Health]

What you describe suggests that your father has a condition called, achalasia.  The term achalasia means "failure to relax", in this instance a failure of the valve between the esophagus and stomach, to relax.  This leads to obstruction of food going into the stomach with regurgitation, regurgitation and aspiration pneumonia.  There is no cure for this disease, but pneumatic dilation of the sphincter, commonly called a valve, or surgical myotomy, which is partial cutting of the valve, offer long-lasting benefit and are considered optimal treatment.

If this abnormality is uncorrected, your father will continue to get aspiration pneumonia and eventually die of it.  You should request consultation with a gastroenterologist, commonly called a GI specialist, who will be able to recommend the best treatment for your father's condition.

Good luck.

[CrabbyRoad]

Thank You! As of this writing since I first posted my inquiry, he has been sent back to the rehabilitation hospital, as mostly neurologists have been seeing him, and the latest doctor stated, just didn't know anything else to do, was uncomfortable and basic uncharted territory for them. Recommended to keep feeding tube in, and completely abstain from ALL foods for 30 days to relax the muscle and keep elevation of head when sleeping. They tend to think it is a form of neuropathy, what kind is up in the air. In just doing my own research, I thought perhaps autonomic neuropathy-maybe that is just a "vague" description. But I tend to think after your response it is achalasia possibly co-morbid autonomic neuropathy, if that is possible. But I thank you kindly for answering, as they are persistent in wanting him to be still seen only by a new neurologist later this week-dismissing the gastroenterology due to the test results that had been performed.