Is it common to get pneumonia frequently after having a stoke?

Deathana asked...

Hi, is it normal to get pneumonia so often since stroke? My grandfather had two strokes last May, causing him disabilities until now - can't sit, talk, eat, walk, etc. We've been feeding him milk through the tube in his nose ever since. I'm worried about his pneumonia. Yesterday he was admitted to the hospital again - his 3rd time being rushed to the hospital for pneumonia since his stroke last May. Is this normal? I'm really worried. It seems to come and go like flu to him. I know it is an infection of the lungs, and even his own saliva could cause this. Perhaps anything we're doing wrong at home? His pillow is too low or something like that? Or anything we can do to avoid this from happening again? It kills me to see my grandfather so helpless like this. I'm studying abroad so I feel helpless as well - this is the 3rd time I got news of him being rushed to the hospital by ambulance for pneumonia. It's scary.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Unfortunately, pneumonia is one of the most common complications after a stroke. The cause is almost always "aspiration". In other words, your grandfather's mouth muscles are not coordinated enough to prevent saliva, food, etc. from going into the lungs.

If he is still being fed by a tube through the nose, as you have suggested above, that is not ideal. This far out from a stroke, if swallowing is a problem, he should have a PEG tube directly to the stomach. I would check with a Speech Pathology (who also sees patients for swallowing issues) to see if a PEG tube would be a better alternative. They may also have good advice for what to avoid putting in his mouth, how he should be situated (what angle he should be sitting at during the day and at night), etc. In general, patients do better when they are up at an angle, rather than lying flat on their back. Overall, having three aspiration pneumonias after a stroke is a bit unusual. If you are already seeing a Speech Pathologist, I would probably get a second opinion given the number of pneumonias that have occurred.

Good luck!