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Oropharyngeal Dysphagia with Aspiration as a Provoking Factor for COPD Exacerbation

Received: 6 February 2019     Accepted: 11 March 2019     Published: 26 March 2019
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Abstract

The most common provoking factors for chronic Obstructive Pulmonary Disease (COPD) exacerbation include viral and bacterial tracheobronchitis, pneumonia, and exposure to environmental irritants and air pollution. In many patients with COPD exacerbation, the underlying cause cannot be identified. In general, patients with COPD exacerbation get admitted to the hospital and treated with antibiotics, glucocorticoids and inhaled bronchodilators. Oropharyngeal dysphagia is an under-recognized provoking factor for COPD exacerbation. Patients with advanced COPD often have impaired coordination of respiration and deglutition which can lead to aspiration of liquids, food particles, and saliva into the airways. Aspiration events can lead to exacerbation of symptoms and cause further decline in lung function. We described a 69-year-old male with a history of COPD who presented with progressive dyspnea, productive cough and hypoxia which required intubation and mechanical ventilation. The patient underwent a bronchoscopy for airway inspection which showed pieces of meat in the right main bronchus which were removed. Reportedly, the patient was having difficulty swallowing solid food prior to admission to the hospital.

Published in American Journal of Internal Medicine (Volume 7, Issue 1)
DOI 10.11648/j.ajim.20190701.14
Page(s) 12-14
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Chronic Obstructive Pulmonary Disease (COPD), Swallowing Dysfunction, Oropharyngeal Dysphagia, Aspiration

References
[1] Tsuzuki A, Kagaya H, Takahashi H, Shioya T, Sakakibara H, et al. Dysphagia causes exacerbation in individuals with chronic obstructive pulmonary disease. J Am Geriatric Soc 2012; 60 (8): 1580-1582.
[2] O’Kane L, Groher M, Oropharyngeal Dysphagia in Patient with and obstructive pulmonary disease: a Systematic review. Rev CEFAC 2009; 11 (3): 499-506.
[3] Steidl E, Ribeiro CS, Goncalves BF, Fernandes N, Antunes V, Mancopes R. Relationship between Dysphagia and exacerbation in chronic Obstructive Disease. A literature review. International Archives of Otorhinolaryngology. Vol 19, Page 74-79. No 1/ 2015.
[4] Donaldson GC, Wedzicha JA, COPD exacerbations. 1: Epidemology. Thorax 2006; 61: 164-8.
[5] Terada K, Muro S, Ohara T, Kudo M, Ogawa E, Hoshino Y and Hirai T, Niimi A, Chin K, Mishima M. Abnormal swallowing reflex and COPD exacerbation. Chest, 137 (2), 326-332. 2009.
[6] Mokhlesi B, Logemann JA, Rademaker AW, et al. oropharyngeal deglutition in stable COPD. Chest 2002; 121: 361-9.
[7] Stroud, Jayma. "Disordered Coordination of Deglutition and Respiration in Chronic Obstruction Pulmonary Disease." Research Papers (2014): Paper 480.
[8] Gross R, Atwood C, Ross S, Olszewski J, and Eichorn K, The coordination of breathing and swallowing in chronic obstruction pulmonary disease. American Journal of respiratory and Critical care Medicine, Vol 179, 559-565, 2009.
[9] Kobayashi, S., Kubo, H., Yanai, M. (2007). Impairment of the swallowing reflex in exacerbations of COPD. BMJ Journals, 62 (11).
[10] Cvejic, L., Harding, R. Churchward A, Turton A., Finlay P., Massey D. et al. (2011). Laryngeal Penetration and aspiration in individuals with stable COPD. Respirology, Asian Pacific Society of Respirology. 16, 269-275. 2011.
[11] Good-Fratturelli, M. D., Curlee, R. F., Holle, J. L. Prevalence and nature of dysphagia in VA patients with COPD referred for Videofluoroscopic swallow examination. (2000) Journal of Communication Disorders, 33 (2), 93-110.
[12] Lee, Annemarie, and Roger Goldstein. "Gastroesphageal Reflux Disease in COPD: Links and Risks." International Journal of COPD (2015): 1935-949.
[13] Terada, K., S. Muro, S. Sato, T. Ohara, and A. Haruna. "Impact of Gastro-oesophageal Reflux Disease Symptoms on COPD Exacerbation." BMJ 63 (2008): 951-55.
[14] Coelho, C. Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease. Dysphagia 1987; 2 (1): 28-31.
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  • APA Style

    Noor Sameh Darwich, Shamsuddin Chowdhry Pracha, Natalie Ann Miller. (2019). Oropharyngeal Dysphagia with Aspiration as a Provoking Factor for COPD Exacerbation. American Journal of Internal Medicine, 7(1), 12-14. https://doi.org/10.11648/j.ajim.20190701.14

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    ACS Style

    Noor Sameh Darwich; Shamsuddin Chowdhry Pracha; Natalie Ann Miller. Oropharyngeal Dysphagia with Aspiration as a Provoking Factor for COPD Exacerbation. Am. J. Intern. Med. 2019, 7(1), 12-14. doi: 10.11648/j.ajim.20190701.14

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    AMA Style

    Noor Sameh Darwich, Shamsuddin Chowdhry Pracha, Natalie Ann Miller. Oropharyngeal Dysphagia with Aspiration as a Provoking Factor for COPD Exacerbation. Am J Intern Med. 2019;7(1):12-14. doi: 10.11648/j.ajim.20190701.14

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  • @article{10.11648/j.ajim.20190701.14,
      author = {Noor Sameh Darwich and Shamsuddin Chowdhry Pracha and Natalie Ann Miller},
      title = {Oropharyngeal Dysphagia with Aspiration as a Provoking Factor for COPD Exacerbation},
      journal = {American Journal of Internal Medicine},
      volume = {7},
      number = {1},
      pages = {12-14},
      doi = {10.11648/j.ajim.20190701.14},
      url = {https://doi.org/10.11648/j.ajim.20190701.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20190701.14},
      abstract = {The most common provoking factors for chronic Obstructive Pulmonary Disease (COPD) exacerbation include viral and bacterial tracheobronchitis, pneumonia, and exposure to environmental irritants and air pollution. In many patients with COPD exacerbation, the underlying cause cannot be identified. In general, patients with COPD exacerbation get admitted to the hospital and treated with antibiotics, glucocorticoids and inhaled bronchodilators. Oropharyngeal dysphagia is an under-recognized provoking factor for COPD exacerbation. Patients with advanced COPD often have impaired coordination of respiration and deglutition which can lead to aspiration of liquids, food particles, and saliva into the airways. Aspiration events can lead to exacerbation of symptoms and cause further decline in lung function. We described a 69-year-old male with a history of COPD who presented with progressive dyspnea, productive cough and hypoxia which required intubation and mechanical ventilation. The patient underwent a bronchoscopy for airway inspection which showed pieces of meat in the right main bronchus which were removed. Reportedly, the patient was having difficulty swallowing solid food prior to admission to the hospital.},
     year = {2019}
    }
    

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    AU  - Noor Sameh Darwich
    AU  - Shamsuddin Chowdhry Pracha
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    DO  - 10.11648/j.ajim.20190701.14
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    AB  - The most common provoking factors for chronic Obstructive Pulmonary Disease (COPD) exacerbation include viral and bacterial tracheobronchitis, pneumonia, and exposure to environmental irritants and air pollution. In many patients with COPD exacerbation, the underlying cause cannot be identified. In general, patients with COPD exacerbation get admitted to the hospital and treated with antibiotics, glucocorticoids and inhaled bronchodilators. Oropharyngeal dysphagia is an under-recognized provoking factor for COPD exacerbation. Patients with advanced COPD often have impaired coordination of respiration and deglutition which can lead to aspiration of liquids, food particles, and saliva into the airways. Aspiration events can lead to exacerbation of symptoms and cause further decline in lung function. We described a 69-year-old male with a history of COPD who presented with progressive dyspnea, productive cough and hypoxia which required intubation and mechanical ventilation. The patient underwent a bronchoscopy for airway inspection which showed pieces of meat in the right main bronchus which were removed. Reportedly, the patient was having difficulty swallowing solid food prior to admission to the hospital.
    VL  - 7
    IS  - 1
    ER  - 

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Author Information
  • Faculty of Medicine, University of Jordan, Amman, Jordan

  • Department of Medicine, Kettering Medical Center, Kettering, Ohio, USA

  • Department of Physical Medicine, Rehabilitation and Speech Therapy, Sycamore Hospital, Miamisburg, Ohio, USA

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