Hypersalivation (hypersialia) is a pathological condition characterized by excessive production and secretion of saliva into the oral cavity. This disorder frequently accompanies inflammatory processes, intoxications, and neurological disorders.
Core MechanismPathological increase in salivary gland secretion.
Alkalinization: Saliva dilutes gastric juice, increasing its pH.
Reduced defense: Altered acidity decreases the bactericidal and bacteriostatic activity of the juice.
Impaired fermentation: Peptic activity drops, making protein digestion more difficult.
Motility: The evacuation of gastric contents into the duodenum is accelerated.
Complications
In addition to digestive disorders, prolonged hypersalivation poses a risk of hypohydration. In severely ill patients, constant drooling or frequent spitting leads to significant fluid loss, requiring correction of the water-electrolyte balance.
Which neurological diseases and syndromes are accompanied by hypersalivation?
Hypersalivation/sialorrhea is indicated in the following neurological conditions, forms, and syndromes:
Parkinsonism / Parkinson's disease — external manifestations of hypersalivation are observed in parkinsonism; in Parkinson's disease, sialorrhea is associated with hyperproduction of saliva and/or swallowing disorders.
Bulbar syndrome — may manifest as swallowing disorders, choking, nasal voice, paresis of the soft palate, and hypersalivation.
Pseudobulbar syndrome — externally manifests as hypersalivation; true hypersecretion of saliva may be absent, and saliva pooling is caused by hypokinesia of the tongue, pharyngeal muscles, and swallowing disorders.
Bulbar and mixed forms of the described lesions — represent the most dangerous variants and manifest with bulbar syndrome and hypersalivation.
Encephalitic stage with the triad "hydrophobia, profuse sweating, hypersalivation" — hypersalivation is listed as part of this pathognomonic triad.
Poisoning by which exogenous poisons and toxins leads to hypersalivation?
Increased salivation/hypersalivation is indicated in poisoning or intoxication by the following exogenous poisons and toxins:
Mercury compounds — cited as a cause of exogenous intoxication with hypersalivation.
Nicotine — cited as a cause of exogenous intoxication with hypersalivation.
Muscarine and muscaridine — mushroom toxins; their action is described as causing profuse sweating, salivation, and bronchorrhea.
Amanitin, phalloin, phalloidin — toxic thermostable mushroom alkaloids; poisoning by them is noted to cause profuse salivation.
Which pharmacological groups of drugs cause hypersalivation?
Pharmacological groups and drugs for which increased salivation or drooling is indicated:
Anticholinesterase agents — enhance salivation; in cases of sialorrhea, it is recommended to discontinue them or reduce the dose if possible.
Antipsychotics — among the anticholinergic side effects of neuroleptics, dry mouth is noted, occasionally accompanied by drooling.
Specific drugs that increase salivation include quetiapine and clozapine.
How does hypersalivation affect the bactericidal property of gastric juice?
Excess saliva dilutes and alkalinizes gastric juice, suppressing its natural bactericidal and bacteriostatic capacity.
Why is there a risk of dehydration in hypersalivation?
Hypohydration develops due to continuous fluid loss from frequent spitting or involuntary drooling.
How does gastric motility change with an excess of saliva?
There is an acceleration of the evacuation of gastric contents into the duodenum.
Go deeper
Mechanisms of autonomic regulation of salivary gland secretion.
Differential diagnosis of stomatitis causing hypersalivation.
Biochemical composition of saliva in various types of intoxications.
Pathophysiological methods for correcting water-electrolyte disturbances in chronic hypersalivation.