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excessive flow of saliva

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/03/24 04:23:00」(JST)

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Hypersalivation (also called ptyalism^[1] or sialorrhea^[2]) is excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.^[3]

Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or in difficulty in swallowing the excess saliva (dysphagia).

Hypersalivation also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit).^[4]

Causes

Excessive production

Conditions that can cause saliva overproduction include:^[3]

Rabies
Pellagra (niacin or Vitamin B3 deficiency)^[5]
Gastroesophageal reflux disease, in such cases specifically called a water brash, and is characterized by a sour fluid or almost tasteless saliva in the mouth^[6]
Gastroparesis (main symptoms are nausea, vomiting, and reflux)
Pregnancy
Excessive starch intake
Anxiety (common sign of separation anxiety in dogs)
Pancreatitis
Liver disease
Serotonin syndrome
Mouth ulcers^{[medical citation needed]}
Oral infections

Medications that can cause overproduction of saliva include:^[3]

aripiprazole
clozapine
pilocarpine
ketamine
potassium chlorate
risperidone
rabeprazole sodium (Aciphex)

Toxins that can cause hypersalivation include:^[3]

mercury
copper
organophosphates (insecticide)
arsenic

Decreased clearance

Causes of decreased clearance of saliva include:^[3]

Infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis and mumps.
Problems with the jaw, e.g., fracture or dislocation
Radiation therapy
Neurologic disorders such as myasthenia gravis, Parkinson's disease, multiple system atrophy, rabies, bulbar paralysis, bilateral facial nerve palsy, and hypoglossal nerve palsy.

Treatment

Hypersalivation is optimally treated by treating or avoiding the underlying cause.^[3] Mouthwash and tooth brushing may have drying effects.^[3]

In the palliative care setting; anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate.^[7]

References

^ thefreedictionary.com > ptyalism Citing:
- Dorland's Medical Dictionary for Health Consumers. 2007
- Mosby's Medical Dictionary, 8th edition. 2009
- Saunders Comprehensive Veterinary Dictionary, 3 ed. 2007
^ thefreedictionary.com > sialorrhea Citing:
- The American Heritage Dictionary of the English Language, Fourth Edition, Updated in 2009.
^ ^a ^b ^c ^d ^e ^f ^g Medscape > Hypersalivation By Erica Brownfield. Posted: 05/19/2004
^ Clark], [edited by Parveen Kumar, Michael (2005). Kumar & Clark clinical medicine (6th ed.). Edinburgh: Elsevier Saunders. p. 266. ISBN 0702027634.
^ [1]
^ thefreedictionary.com > water brash Citing: Dorland's Medical Dictionary for Health Consumers. 2007
^ Medical Care of the Dying, 4th Edition, 2006, Edited by G.Michael Downing MD and Wendy Wainwright, MEd

UpToDate Contents

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1. 妊娠での母体の消化管の変化 maternal gastrointestinal tract adaptation to pregnancy
2. 妊娠の悪心および嘔吐の臨床的特徴および評価 clinical features and evaluation of nausea and vomiting of pregnancy
3. 妊娠中の異食症 pica in pregnancy

English Journal

Unilateral Parotid Radiation With Electron Beam for Palliation of Sialorrhea in ALS Patients: A Prospective Study.

Dhanireddy B1, Kasarskis EJ2, Bruno M2, Wooten CE1, Vanderpool KE2, St Clair WH1.
International journal of radiation oncology, biology, physics.Int J Radiat Oncol Biol Phys.2016 Oct 1;96(2S):E505-E506. doi: 10.1016/j.ijrobp.2016.06.1896.
PMID 27674872

Aripiprazole-Induced Sialorrhea Responsive to Diphenhydramine Treatment.

Kılınç S1, Hergüner A2, Hergüner S1.
Journal of child and adolescent psychopharmacology.J Child Adolesc Psychopharmacol.2016 Oct;26(8):767-768. Epub 2015 Sep 23.
PMID 26397172

Pathophysiology underlying drooling in Parkinson's disease: oropharyngeal bradykinesia.

Karakoc M1, Yon MI2, Cakmakli GY3, Ulusoy EK4, Gulunay A5, Oztekin N6, Ak F6.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology.Neurol Sci.2016 Sep 9. [Epub ahead of print]
We aimed to investigate the association between drooling and possible etiological factors in Parkinson's disease (PD) and to determine its effect on the quality of life. Demographic data of the 63 patients with idiopathic PD were recorded. Radboud Oral Motor Inventory for Parkinson's disease (ROMP)
PMID 27613712

Japanese Journal

Nocturnal Hypersalivation Caused by Distigmine Bromide in a Patient with Multiple System Atrophy

Suzuki Keisuke,Miyamoto Tomoyuki,Miyamoto Masayuki,Hirata Koichi
Internal Medicine 47(10), 983-984, 2008
NAID 130000078691

口腔心身症に関する臨床的検討

三原学,深谷昌彦,高井克憙,稲本浩,榊原一彦
日本口腔外科学会雑誌 31(1), 96-103, 1985
… There have been many patients suffering from psychomatic diseases in all clinicsin recent years.<BR>In twenty patients with a psychomatic disease in the oral region (glossodynia, unidentified pain, halitosis and ptyalism), clinical studies on brief psychotherapy. …
NAID 130001358276

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