Can acid reflux cause excess saliva? What is a water brash?

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Yes, excess saliva production – also called hypersalivation – is one of the symptoms of acid reflux.

Stomach acids flowing back to the esophagus might act as irritants, the salivary glands try to get rid of the irritants by overproducing saliva.

The excess saliva combined with the stomach acids flowing up in your esophagus can cause a water brash or acid brash. The result is a bad taste in the mouth, might feel like bile, and can cause teeth problems in the long term.

Why does the body produce saliva?

Produced by the salivary glands in the mouth, saliva plays an important role in maintaining a healthy oral microbiota.

Even though 98%+ of saliva is water, the other 1-2% contains mucus, proteins, mineral salts, and amylase, all of which help in one way or the other to stay healthy. Saliva helps to:

How much saliva do we produce?

Daily saliva production is usually between 0.5 and 1.5 liters. Secretion is mainly controlled by the autonomous nervous system.

It is normal to produce more saliva while and shortly after eating, especially when eating spicy foods. While sleeping, the saliva production rate is significantly lower.

Not enough saliva production can cause dry mouth, too much can lead to drooling or water brashes.

Both the quality and quantity of saliva production can be affected by a wide variety of medical conditions and drugs.

Causes of excess saliva

Excessive mouth-watering or drooling can be caused by a number of very different factors (1, 2, 3). It is important to assess other symptoms as well in order to find out the real cause and the appropriate treatment.

The most common causes of excess saliva are:

Excess saliva after eating

As mentioned above, slightly increased saliva production after eating is perfectly normal, that’s how the body works. Especially after hot, spicy foods, we tend to produce more saliva.

However, drooling, the difficulty of swallowing is not normal.

If excess saliva production is related to eating, and it is accompanied by a sour taste in the mouth (water brash), chest pain, heartburn, regurgitation, it is not normal.

Acid reflux or GERD affects about 20% of people in the US. If your excess saliva production only happens after eating, especially if you also experience the above-mentioned symptoms, chances are acid reflux is the cause.

Heartburn & excess saliva

Research shows there is a connection between acid reflux and excess saliva production.

During an acid reflux attack, stomach acids enter the esophagus. According to WebMD, the salivary glands respond to this by increased saliva production – the ‘esophago-salivary’ reflex – in order to help remove the acid from the esophagus, but this can actually worsen your condition.

The result can be heartburn, water brash, sour taste in the mouth, all of them are common acid reflux symptoms.

When to consult a doctor? What doctor to see for hypersalivation?

If you have permanent hypersalivation or drooling and don’t know the cause (e.g. allergy, medication, etc.), it’s best to consult your doctor.

Diagnosing the cause of hypersalivation can be quite complicated, it’s quite possible that you’ll be asked to visit an otolaryngologist or a salivary gland specialist. Such doctors have special education and experience in salivary gland problems.

If you have temporary hypersalivation but are unsure of the cause, it is still a good idea to consult your doctor.

How to treat excess saliva?

Treatment depends on the cause of excess saliva production. That’s why it is very important to consult an experienced doctor, as mentioned above.

If you know that your excess saliva production is related to acid reflux, dietary and lifestyle changes should be the first thing you try.

Certain medications can decrease saliva production, however, they not only have side effects, but they also treat the symptom, not the cause.

Sometimes botox might be recommended, which prevents the gland from producing saliva, but this is only a temporary solution (lasts for a few months), and again addresses the symptom, not the cause.

In severe cases, when the underlying problem cannot be diagnosed or cured, surgery or radiation therapy might be required.

Water brash treatment at home

Frequent water brashes can damage the lining of your esophagus, so it’s best to consult a doctor about possible solutions. However, there are a number of home remedies that can help relieve the pain:

Frequently asked questions

Can acid reflux cause thick, mucus-like saliva?

Thick saliva is usually a sign of dehydration. Make sure you drink enough water to thin out your saliva.

If you spit out the saliva instead of swallowing it, you might easily get more dehydrated, watch out for that!

What causes brown saliva?

This usually means blood in the saliva. When your saliva or mucus is red, it means fresh blood, when it’s brown, it means old blood.

Either way, if you think there is blood in your saliva, you should consult your doctor!

Why is my saliva white/foamy?

Besides reflux, this can indicate a problem with the lungs, heart, etc.

If you have other symptoms like heartburn, burping, regurgitation, it can be acid reflux. It’s best to visit a doctor for a diagnosis.