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Medical Forum / General / General / November 2006

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salty saliva for 5 months

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william - 18 Nov 2006 13:31 GMT
White male aged 52 reporting intensely salty saliva all day every day
for over 5 months. If he flosses between the front lower incisors, the
salty taste increases as if he had dislodged salt from between the teeth.

Stopping medications -- Nexium (for GERD) and Lipitor 20mg (for high
cholesterol) -- for a month has not affected the saltiness.

Routine blood test for statin followup shows everything within normal
range (except for high cholesterol and triglycerides).

Routine dental exam has revealed nothing out of the ordinary.
Changing toothpaste has not changed the salty taste.

Sinuses clear-- no post-nasal drip.

Patient drinks plenty of water. Dehydration not an issue.

Patient has made an appointment with ENT specialist but it is 90 days in
the future.

Are there any tests the primary care physician could run in the meantime
to speed the diagnosis? Is it possible to test the saliva itself? Would
higher concentrations of certain chemicals in the saliva lead towards
one diagnosis and away from others?

Thanks
White Male, aged 52
Howard McCollister - 20 Nov 2006 13:05 GMT
> White male aged 52 reporting intensely salty saliva all day every day for
> over 5 months. If he flosses between the front lower incisors, the salty
[quoted text clipped - 20 lines]
> higher concentrations of certain chemicals in the saliva lead towards one
> diagnosis and away from others?

One of the most common causes of a salty or sour taste in the most is GERD.
This can persist even without heartburn or other more classic signs of
reflux. Anti-acid medications like Nexium may not help - in fact they may
even increase the problem by suppressing stomach acid and allowing bile
salts to precipitate in the stomach, and those salts are still definitely
available to reflux into the mouth. Non-acid reflux occurs in 25% - 40% of
GERD patients and there are no medications to control it.

To nail that diagnosis down further a complete medical history needs to be
done. You should indeed raise the issue with your doctor, perhaps even go
ahead with the ENT appointment, but ignorance about the finer aspects of
GERD is common, and the concept of non-acid reflux is not one your typical
FP or ENT is likely to be familiar with. An alarming number of
gastroenterologists are woefully ignorant of the subject as well, but they
or someone well-versed in esophageal disease would be the most likely to be
familiar.

Ambulatory pH testing is the method by which GERD is confirmed, but standard
pH testing by either catheter or Bravo methods won't diagnose non-acid
reflux since it is alkaline not acid. It can only be accurately diagnosed by
MII (multi-channel intraluminal impedance) testing.

HMc
REP - 20 Nov 2006 14:33 GMT
> One of the most common causes of a salty or sour taste in the most is GERD.

Out of curiosity, are there other non-dental, non-sinus, non-gastric
causes? Is it a significant enough symptom to mention to one's doctor? I
have had the salty thing on occasion for months and had always assumed
it was just another thing associated with kidney disease and have not
brought it up. (Not looking for a dx - just whether to pester my doctor.)

Signature

"Did Father shoot him? I will eat Grandfather for dinner."
- Helen Keller, on learning of the death of her grandfather

email: aripee at inanna . com

Howard McCollister - 22 Nov 2006 03:15 GMT
>> One of the most common causes of a salty or sour taste in the most is
>> GERD.
[quoted text clipped - 4 lines]
> it was just another thing associated with kidney disease and have not
> brought it up. (Not looking for a dx - just whether to pester my doctor.)

That's a good question, but I'm sorry, I don't know the answer.

HMc
 
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