March 2, 2026 With the collaboration of Prof. José Roquette Aspiration or inhalation of foreign substances into the airways can cause immediate signs, but it can also go unnoticed when, at the time it occurs, no cough or other symptoms are triggered. Sometimes, the signs appear only hours later or develop gradually over a few days. It all depends on the person, their age, previous health status, the substance aspirated and in what quantity. In some cases, the situation can be resolved with coughing and expulsion of the substance, but in others it can lead to the development of aspiration pneumonia . The severity of this pneumonia is variable ; it can be treatable, but it can also be severe and potentially fatal. Knowing the signs and being attentive is important to intervene in time. Immediate signs of aspiration When food, liquids, saliva, gastric contents, or any other foreign body enters the airways, the immediate signs are: A feeling of choking and a sudden repeated cough in an attempt to expel them. Difficulty breathing , shallower, faster, and even noisy breathing. Alteration of the usual tone of voice when trying to speak, sounding like speaking with water in the throat. There may also be an uncomfortable sensation in the chest , as if something is scratching. In more severe cases, difficulty breathing compromises gas exchange, and the lips may turn bluis h. Symptoms that develop progressively In more fragile people and those at higher risk, aspiration can be silent, either because the cough is not triggered or because the other signs are more difficult to detect at the time. In addition, the affected person may also be unable to manifest clearly. Associated with aspiration pneumonia, respiratory and other signs develop progressively: Persistent dry cough or cough with expectoration . Shortness of breath or difficulty breathing , rapid breathing, and often chest pain when breathing. Fever, chills, weakness, loss of appetite, drowsiness, and evident fatigue accompany the progression of respiratory symptoms. Aspiration pneumonia can be very serious, even fatal There are warning signs related to the severity of this pneumonia that should always prompt an urgent search for medical attention : Very rapid breathing. Decreased blood pressure. Mental changes, with confusion, particularly in the elderly. Bluish lips and nails. Profuse sweating. Treatment of aspiration pneumonia Treatment depends on the type of substance aspirated, the consequences and severity of the pneumonia it caused and the particularities of each person. Imaging tests and invasive procedures, including surgery, is common to remove foreign substances that are causing blockages , compromising the viability of lung tissue. It may also be necessary to remove lung tissue whose functionality cannot be recovered , which happens more frequently with the middle lobe of the right lung due to issues related to its anatomical particularities. Whether or not these interventions are necessary, the treatment of aspiration pneumonia may also include: Antibiotics, when pneumonia is caused by bacteria. Medicines to control fever and inflammation. Supportive measures, like oxygen administration, maintaining hydration, respiratory physiotherapy, avoiding lying down position and promoting mobility. After recovery, a detailed assessment of the likely cause of aspiration should be made and appropriate measures taken to try to prevent it from happening again . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
