Foreign bodies in the lungs - This is what you should be doing

Introduction: what is a foreign body in the lungs?

In the event of a foreign body aspiration, a foreign substance (usually unintentionally) gets into the lungs.

This happens most often with children who "choke" while eating, for example.
Instead of the food entering the esophagus, it ends up in the windpipe and from there to the lungs.

In adults, foreign body aspiration usually occurs when they are unconscious or have difficulty swallowing.
Anything that does not belong in the lungs and is solid (not liquid or gaseous) is called a foreign body.

Also read our article: Difficulty swallowing - that's behind it

This is how a foreign body in the lungs is treated

The therapy for a foreign body aspiration must be adjusted depending on the symptoms.

Most foreign bodies can be pushed out of the lungs by coughing.
But especially when children choke, for example, the foreign bodies tend to get caught so that the child does not cough them out.
A pat on the back can help to loosen the foreign body.

If this is not enough and if there is a shortage of breath, possibly even with a risk of suffocation, the child can be positioned so that the head points downwards at an angle.
The foreign body can usually be loosened by (careful but targeted) blows on the back, gravity pushes it out of the airways.

Tapping on the back also helps with adults.
If the foreign body cannot be removed from the lungs in this way, an attempt is made to remove it with a bronchoscopy.
A rigid tube is inserted into the windpipe.
At the top are a small camera and instruments that can be used to get the foreign body out.

If this does not succeed, surgical removal of the foreign body may be necessary in an emergency.

This is the prognosis for an aspirated foreign body

The prognosis is better, the sooner the aspiration is noticed and the sooner the foreign body can be removed.

With adequate therapy, most foreign body aspirations end harmlessly and without any sequelae.
But pneumonia (aspiration pneumonia) in particular, which is triggered by pathogens, can cause permanent lung damage.

Also unconscious, who in addition to foreign bodies often aspirate part of their gastric juice, often suffer from inflammation of the lung tissue afterwards.

Anyone who has chronic swallowing disorders and therefore chokes more often has chronic inflammation in the lungs, which gradually damages the lung tissue.

Coughing helps after swallowing a foreign body

Coughing is a protective reflex of the body.
Foreign substances (foreign bodies, but also liquids, pathogens, etc.) should be jerked out of the lungs and airways.
A foreign body that gets stuck in the lungs or the airways triggers repeated coughing. If the windpipe is injured during aspiration, bleeding can occur, which is expressed as coughing up blood.

Foreign body complications in the lungs

Foreign bodies can cause very different complications depending on their size, shape and consistency.
Contamination of the foreign body can also play a role.

If the foreign body is removed quickly and completely from the lungs, there are usually no complications.
However, the longer the foreign body remains in the lungs, the more the organ reacts to the foreign substance.
This can range from a mild local inflammatory reaction to generalized inflammation.
Pneumonia (aspiration pneumonia) can develop, especially if there are additional pathogens on the foreign body.

If certain sections of the lungs are blocked over a longer period of time, they can collapse and grow together.
What remains is the adhesion and scarring of the tissue.

In rare cases, a valve mechanism can occur during foreign body aspiration.
Air can still get into the lungs, but the foreign body prevents the air from being exhaled again.
The lungs over-inflate and shortness of breath occurs, which in the worst case leads to permanent lung damage or death.

Causes of Foreign Body Aspiration

The main cause of foreign body aspiration in children is their inadequately developed swallowing act.
The children first have to learn how the muscles in the mouth have to be coordinated so that the food ends up in the esophagus.
Distraction can quickly lead to aspiration (swallowing).

Adults usually master the act of swallowing.
Foreign bodies get into their lungs when they are suddenly surprised and distracted while eating.
In addition, swallowing disorders and loss of consciousness can lead to foreign body aspiration.

You can recognize a foreign body in the lungs by these symptoms (foreign body aspiration)

Immediately after you have choked, there is usually a strong urge to cough.
This is the expression of a protective reflex of the body, which tries to get the foreign body out of the lungs again.

If the foreign body obstructs part of the airways, a whistling sound can be heard when breathing in or out.
In addition, a persistent urge to cough can occur.
It is not uncommon for small injuries to the windpipe to occur, which can result in small amounts of blood appearing when coughing.

In the worst case, the foreign body aspiration manifests itself as shortness of breath.

How does the doctor diagnose a foreign body in the lungs?

Diagnosing a foreign body in the lungs is usually very easy based on a clear medical history.
If this does not succeed, the lungs can be monitored.
You can hear weakened breathing noises or a whistle if the foreign body blocks access to part of the lungs.
If you are not sure whether there is a foreign body aspiration, an X-ray can also be taken.
On this one can usually see the foreign body well due to its density.