How I Manage Drooling, Saliva, and GERD in Parkinson’s

Some people with Parkinson's disease develop excessive drooling, the medical term is sialorrhea. I am a speech pathologist who has Parkinson's disease. I have also evaluated and treated many people with Parkinson's for drooling, voice, and swallowing difficulties.

When I produce too much saliva, it pools in my mouth and causes me to drool. I am starting to lose my ability to control the excess saliva due to bradykinesia, including a breakdown of my lip muscular control.¹

For me, bradykinesia contributes to muscle weakness and rigidity in my mouth, face, and neck. I am starting to have decreased control of my saliva, too. Sometimes, I experience drooling and other swallowing issues.

Controlling excess saliva

As a speech pathologist, I evaluate and treat people who are at risk of aspiration pneumonia and other associated swallowing difficulties. Some of my patients cannot manage the pooling of excess saliva in the mouth and seek treatment. They may exhibit bradykinesia or slowness of movement, and as a result, they swallow less often. Currently, I personally do not drool much, but my doctor prescribed medicine that goes under my tongue and helps control my excess saliva.

Some doctors may reduce drooling by injecting Botox, or botulinum toxin A, into the salivary glands. Only experienced medical specialists are trained on which salivary gland should be used. They will determine the right amount of botulinum toxin that should be injected.¹

My experience with GERD

Some people with Parkinson's disease experience heartburn (gastroesophageal reflux). I have severe gastroesophageal reflux disease (GERD). I can acutely feel the backward burning flow of stomach acid shooting up with the contents of my stomach, through my esophagus into my mouth.².

The acid in my stomach greatly irritates the lining of my esophagus and it is causing me to develop Barrett's esophagus. GERD also causes me difficulty with my swallowing and increases excess salivation.

To reduce GERD, I practice:

1. Eating and drinking my food and liquids slowly
2. Sleeping with my head elevated at 45 degrees by using pillows
3. Raising the head of my bed a few inches - I put blocks under the front legs of my headboard to increase elevation
4. Reducing alcohol intake
5. Eating smaller meals
6. Sipping on water to reduce the saliva in my mouth
7. Following a GERD diet that is prescribed by a dietician

My gastroenterologist prescribed medicine to control my GERD after I tried most of the over-the-counter and at-home remedies without relief. My doctor prescribed me Dexilant to treat my GERD successfully. Please consult your physician to see which medication is recommended for your unique condition.

Impact on daily activities

In sum, my excessive GERD continues to interfere with my daily activities. It can also lead to other medical conditions such as the erosion of my esophagus, Barrett's esophagus, and hiatal hernia. In addition to medical intervention, I practice my GERD recommendations daily so I do not have to suffer from excessive GERD anymore.

Finally, excessive drooling can interfere with socialization. When going out socially, others may be disturbed by the sight of the person drooling. Friends may shy away from socializing with you. Some people with Parkinson's who drool wear bibs and wrist bands to wipe away the saliva. Talk to your doctor or speech pathologist about options that might help if you are experiencing any of these symptoms.