COPD is a disease of the respiratory system. COPD stands for Chronic Obstructive Pulmonary Disease and includes such conditions as emphysema, chronic bronchitis, and asthma. People with COPD and other lung diseases can develop a swallowing dysfunction called DYSPHAGIA. Dysphagia can often have severe consequences including an exacerbation or worsening of COPD and pneumonia. Swallowing and respiration are the only two systems in the body that share a common part of the body, namely the throat. Swallowing and respiration are considered reciprocal functions. This means that when we are swallowing, we should not be breathing and when we are breathing, we should not be swallowing. It takes finely coordinated movements of many muscles to achieve proper timing of this! People with COPD often have trouble with this timing. The airway closing during swallowing is called an apneic period. During a whole meal, there are hundreds of these apneic periods. Sometimes, when people have lung disease, this causes increase shortness of breath and fatigue. This fatigue may result in poor timing between respiration and swallowing. Sometimes, a person with COPD or lung disease may inhale vs. exhale after the swallow which causes penetration or “aspiration” of food or liquid into the trachea (the tube to the lungs) or the larynx (voice box) . This is can cause “Aspiration Pneumonia”.
Suggestions to increase safety during meals:
- Eat at a slow rate
- Put the fork/spoon down between bites to help slow down
- Avoid drinking through straws
- Avoid consecutive drinking of liquids as this requires sustaining airway closure which is difficult for people with lung disease
- Do not eat when short of breath
- Do not exercise immediately prior to eating
- Take small bites and sips
- ALWAYS eat in an upright position and do not lie down right after eating
- Do not talk and eat at the same time. Speech requires coordinated timing of the breathing as does swallowing. Precise timing of both these mechanisms is too difficult for people with lung disease.