Hypersalivation
Hypersalivation, also known as sialorrhea or ptyalism, is when a person has too much saliva in their mouth. It can result in saliva from the mouth spilling over the bottom lip. Sialorrhea is not a disease but usually a symptom of another underlying condition, very commonly, Amyotrophic Lateral Sclerosis (ALS).
Sialorrhea patients experience problems swallowing and often notice that they seem to salivate more. The fact is, the patient isn’t producing more saliva, but the saliva is pooling in the mouth because of an inability to swallow. The throat weakens, which is needed for regular swallowing, and when not properly managed can result in drooling, choking or difficulty speaking.
Sialorrhea patients have treatment options however it varies on the underlying cause of the diagnosis. Home remedies may relieve symptoms temporarily, however chronic hypersalivation usually requires more advanced treatment. Options include:
- Anticholinergic Medication which blocks nerve impulses to the salivary glands so that they produce less saliva. There are several side effects with medication including dry mouth, constipation, trouble urinating, blurred vision, hyperactivity and irritability.
- Botulin injections can be administered to patients in the major salivary glands which paralyze the nerves and muscles in the area, preventing the glands from producing saliva. Injections will wear off after a couple of months, so repeat injections will be needed.
- Surgery, in severe cases, can be an option for patients and is performed on the salivary glands by either relocating the glands or removing the glands completely.
- Radiation therapy
Why radiation therapy?
Sialorrhea patients who fail medical and surgical therapy can be excellent candidates for external beam radiation therapy. Radio therapy is delivered to head and neck and aims to spare the parotid glands as it reduces salivation. A great number of ALS patients with salivation problems respond well to therapeutic salivary gland irradiation and the improvement my last for several months.
