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What causes increased salivation and hiccups after taking food?

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General & Family Physician
Practicing since : 1991
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I have a problem with getting hiccups and more or less foaming at the mouth after ingesting a couple of bites of food. This is not frequently, but does occur particularly at dinner when we have a larger meal. I have noted events when eating steak, turkey, etc. It feels as if food sticks in the esophagus. . .I immediately get the hiccups, saliva begins filling my mouith. (feels as if I have an XXXXXXX seltzer in my mouth) The bubbly saliva builds up & I spit it into a napkin. It is clear, although much thicker than saliva & quite bubbly. I continue to spit it up, while hiccuping, coughing and hacking. After about 5 miutes it seems to "break up" and clears". (It reminds me of a sink drain that is stopped-up, then breaks up & drains) The bubbly substance is not vomit, nor does there seem to be any stomach acid. I feel as if I have some type of swelling, scar tissue or some type of ulcer in my esophagus that flares up.
Fri, 4 May 2018 in Digestion and Bowels
Answered by Dr. Bonnie Berger-Durnbaugh 6 hours later
Brief Answer:

Detailed Answer:
Hello and welcome,

Most likely, based on your description, this is esophageal spasm. The muscles of the esophagus tighten and prevent the food from going down. The body reacts with increased salivation and hiccups are possible too. This can be more of a problem with meat.

Your statement "I feel as if I have some type of swelling, scar tissue or some type of ulcer in my esophagus that flares up." is likely a good description of what is going on. There may be inflammation that has happened over time from acid reflux coming up from your stomach into the esophagus, causing irritation.

Other possible causes include achalasia - a problem of the nerves that control the esophagus.

If the problem is caused by previous irritation from acid reflux, I recommend the following:

1. Zantac (ranitidine) 150 mg twice a day. Zantac is an acid reducer that decreases acid production by 70%, allowing the tissues to heal. You may need to take this for a month or longer. I prefer Zantac to the proton pump inhibitors (Nexium, Prilosec, etc) because it is safer and does not have the risk of discontinuation rebound hyperacidity when it is stopped.

2. Do not lie down for 2-3 hrs after eating.

3. Avoid acidic foods - citrus, tomatoes, juices

4. Decrease caffeine (colas, coffee) and sodas in general.

5. Decrease alcohol or completely stop it.

6. If you smoke cigarettes, now is the time to stop. They increase acid production and delay healing.

7. If you are overweight through the middle, that increases the risk of reflux. Try to decrease your weight (if overweight) slowly over time.

8. Eat smaller amounts at a time so there is less pressure in the stomach which can reflux acid into the stomach.

9. Avoid eating/drinking mint (it relaxes the lower esophageal sphincter which can allow more acid up).

If these changes don't help enough, it is time to see your doctor. Your dr. may want you to have an endoscopy (visualizes the esophagus, stomach, with a fiberoptic tube), or manometry (pressure testing of the esophagus).

One more thing which is just an anecdote: I have had patients who tell me that when they feel food has gotten stuck and they get pain in the esophagus, salivation, and hiccups, that sipping tiny bits of sparkling water helps.

I hope this information helps. Please let me know if I can provide further information.
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