Aspirating tiny bits of food or drink

[Mustardfan]

I suspect that I’ve been aspirating tiny bits of food or water into my lungs. For the last 10 years or so I occasionally cough when drinking water. After having a violent cough in January, this was worse, and I also coughed while eating, and found this was better if I ate liquidised good e.g. home made soup. I had two courses on antiobiotics, but found that even after this, I still coughed up yellow phlegm, on and off. I suspect that I’ve had reflux for years (I’ve had a dry cough for years), and that this may have affected my swallowing. I told my GP and they didn’t say much. I’ve seen a respiratory specialist and I’ve had a CT scan (due to my cough). Which showed mild Bronchiectasis. The specialist also didn’t comment on the possible swallowing difficulties. I forgot to ask him about it again when I got the CT result.

Does anyone know what investigations or treatment I should expect regarding possible swallowing issues? How can I know whether or not I am actually aspirating food or fluids? I’ve asked for a referral about the acid reflux.

I’m following the Acid Watcher diet and taking medication for reflux. I now drinking water carefully (slowly). The coughing while eating and drinking has improved, and happens much less now. I’ve got a mild ache at the back of my chest (had it for about 4-5 weeks).

Hi @Mustardfan - I was the one who told you about the AWD, but it sounds like you’re still having issues. Hopefully you will be referred to a good gastroenterologist who ‘gets’ reflux. I am looking in to a RefluxUK appointment as I feel I need more testing (have had quite a bit but AWD isn’t clearing it totally) although my symptoms as much more gastrointestinal. You could ask for a SALT referral re swallowing issues and/or ENT.

My dh has done that coughing after drinking water for years. He now ‘admits’ he has reflux, he saw GP and went on lansaprozole for a month, but it wasn’t particularly effective. I told him to push for an endoscopy.
My adult son also trying to get a reflux diagnosis but even after a camera in the throat via a private ENT they saw throat inflammation and declared it wasn’t reflux/gave nasal sprays, he’s still coughing/throat clearing so he needs to go back to GP. He’s only 20 so impossible for him to change his lifestyle - he just won’t (if my 56 yr old dh won’t, then there’s no hope for DS). I have been chucking gaviscon tablets at DS while he’s home from uni in the vain hope they’ll at least stop the acid from coming up. He’s very delicate mentally so I have to tread carefully.

I was doing fine on the Acid Watcher Diet up until the end of last year, all my symptoms had gone. I then had whooping cough, I was really ill with it, and I don’t think the reflux has settled since. I read a research paper that identified a link between whooping cough and reflux. Maybe I need to give it more time. I’m waiting to see a gastro specialist. I’m also not adhering completely to the diet. I did for around 6 weeks, but I’ve let it slide.

That sounds a frustrating situation with your son (and husband). It’s hard when our kids don’t attend to their health needs, I remember you writing about that before. I wonder what was the basis for the denial of the acid reflux diagnosis.

You might need a Esophageal manometry test.
A tube up your nose and down back of your throat into your esophagus.
Sound very much what l was suffering .
Esophageal spasms .
They gave me BP medication.
Sounds daft but blood pressure medication has helped 99%

Thanks for the suggestion, putyourredshoeson, I’ve looked that up, it describes severe chest pain, mine is a mild ache, so probably not the same.

@Mustardfan - so sorry you had whooping cough, that’s rough. Viruses can worsen reflux - was the case with me and covid.
They don’t believe my son has reflux cos a month on omeprazole did nothing, but he’s got typical lpr symptoms 🤷‍♀️ I’m insisting he goes back to the GP once he gets back to uni.

Gaviscon Advance over other types of Gaviscon, as well as your prescribed reflux meds can really help.

A GP was discouraging to me about taking gaviscon. When I discussed taking it, he said don’t take it for more than two weeks. I don’t know why. That has put me off taking it, and I haven’t taken it for a while, but I’ve decided to take again. I think it helps.

I worked with stroke patients for a long time who potentially had aspiration/swallowing problems we used videofluoroscopy which may be and option for you.

Oh interesting. Our GPs generally seem to think it's a good one and often the ENT consultants suggest it long term.

I'd consider asking for a gastro referral and further investigation such as barium meal / OGD they should be able to look into your reflux difficulties more.

Thanks, that’s useful to know.

The GP who advised me not to take gaviscon for more than two weeks was a GP trainee, I think near the end of his training. I assumed he had some knowledge about it. I don’t know if he did. I’ve gone back on it, and my symptoms have improved. I’m less hoarse.