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July - September 2011: 
Volume 24, Issue 3

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Pneumon 2011, 24(3):271-279
Aspiration syndromes as a cause of bacterial colonization of the lower respiratory tract in children
Abstract
SUMMARY. Aspiration syndromes facilitate the colonization of the lower airways with bacterial pathogens and predispose to recurrent chest infections, chronic suppurative lung disease and bronchiectasis. In recent years important steps forward have been made in the understanding of the physiology of swallowing, the mechanisms underlying gastro-oesophageal reflux and the upper respiratory protective mechanisms for preventing aspiration. The diagnosis of aspiration however, and especially the establishment of a causal association with respiratory symptoms, remains challenging. Aspiration occurs sporadically and intermittently, and its manifestations are non-specific. There is no laboratory test that can establish with certainty whether or not aspiration lung disease is present; the diagnostic approach therefore remains primarily clinical, and laboratory investigations can only strengthen or weaken a clinical suspicion. Pneumon 2011, 24(3):271-279.