Thick Saliva and Foreign Sensation in the Esophagus: Causes and Solutions

Abnormal thick saliva and a sensation of foreign body in the cardia?

Hello Doctor: My saliva has become very thick for the past six months, and I feel like there are always bubbles in my mouth, which is very uncomfortable and distressing.
I can't help but tighten my mouth to avoid the bubbles, using my tongue in various ways to squeeze them out, constantly spitting to try to clear the bubbles or thick saliva, or swallowing saliva repeatedly, but this results in swallowing a lot of air, which makes my stomach uncomfortable as well.
Mentally, I find myself making strange movements with my mouth that significantly affect my life; others probably think I'm very odd.
I want to restrain myself, but it's difficult.
Physically, when it gets severe, I suck hard in my mouth, leaving deep impressions on my tongue and the inside of my cheeks from my teeth, and sometimes I even cause bleeding, which is quite serious.
This behavior occurs not only during the day but also unconsciously at night while I sleep.
Honestly, this has greatly impacted my life, and enduring this for months has been very painful.
I initially thought it might be due to smoking, but I recently quit and have been drinking more water than before, yet there has been no improvement.
I consulted with my long-term psychiatrist, and they said this is not a side effect of the medication.
My eating habits haven't changed much; could this be related to stress? Additionally, I have recently been experiencing a sensation of a foreign body at the junction of my esophagus and stomach (probably the cardia), which coincided with the thick saliva issue.
This sensation is particularly noticeable when swallowing, often feeling like something is stuck, and at times, it even makes me feel nauseous and reduces my appetite, leaving me without a sense of hunger.
In the past, during episodes of binge eating, I would induce vomiting; could this have caused any damage? Do I need to undergo an endoscopy? Thank you for taking the time to read my question.
P.S.
I used to smoke for about two years, averaging 2-3 packs per week, and I have been smoke-free for two weeks now.
I have also been taking SNRI medication (Kang Yue 0.75mg, three times a day) for over two years, along with anti-anxiety and sleep medications (Zopiclone: 0.5mg per day).

Nìmíng de rén, 20~29 year old female. Ask Date: 2016/04/26

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Based on the symptoms, it may be gastroesophageal reflux disease (GERD), and you should consider visiting a gastroenterologist for an endoscopy.

Reply Date: 2016/04/26

More Info

The symptoms you are experiencing, including thick saliva, a sensation of a foreign body in the esophagus, and the compulsive behaviors associated with these sensations, can be quite distressing and may stem from a variety of causes. Let's break down your concerns and explore potential solutions.

Causes of Thick Saliva and Foreign Sensation in the Esophagus
1. Dehydration: Even though you mentioned that you are drinking more water since quitting smoking, it is essential to ensure that you are adequately hydrated. Dehydration can lead to thick saliva, which may feel uncomfortable and contribute to the sensation of having something stuck in your throat.

2. Gastroesophageal Reflux Disease (GERD): The sensation of a foreign body in the esophagus, especially if it is accompanied by nausea or a feeling of fullness, could be related to GERD. This condition occurs when stomach acid flows back into the esophagus, causing irritation and discomfort. Thick saliva can also be a symptom of GERD, as the body may produce more saliva in response to acid irritation.

3. Anxiety and Stress: You mentioned that you have a history of anxiety and have been on medication for it. Anxiety can manifest in various physical symptoms, including changes in saliva production and the sensation of tightness or discomfort in the throat. The compulsive behaviors you described, such as sucking in your cheeks or trying to expel saliva, may be a response to anxiety or stress.

4. Medication Side Effects: While your healthcare providers have indicated that your medications are not causing these symptoms, it is worth considering that some medications can lead to dry mouth or changes in saliva consistency. If you suspect this might be the case, discussing alternative medications with your doctor could be beneficial.

5. Previous Bulimia Symptoms: You mentioned a history of binge eating and purging, which can lead to esophageal irritation or damage. This history may contribute to your current symptoms, as the esophagus can become sensitive or scarred from repeated exposure to stomach acid.

Recommendations and Solutions
1. Hydration: Continue to focus on staying well-hydrated. Drinking plenty of water throughout the day can help thin saliva and reduce discomfort. Consider using a humidifier at night to keep the air moist, which may help alleviate throat irritation.

2. Dietary Adjustments: Pay attention to your diet. Avoiding spicy, acidic, or irritating foods can help reduce symptoms associated with GERD. Eating smaller, more frequent meals may also help prevent reflux.

3. GERD Management: If you suspect GERD, it may be worthwhile to discuss this with your healthcare provider. They may recommend lifestyle changes, over-the-counter antacids, or prescription medications to manage acid reflux.

4. Behavioral Therapy: Since anxiety seems to play a role in your symptoms, consider seeking cognitive-behavioral therapy (CBT) or other forms of therapy that can help you manage anxiety and reduce compulsive behaviors. Mindfulness techniques and relaxation exercises may also be beneficial.

5. Medical Evaluation: Given the persistent nature of your symptoms, it would be prudent to undergo a thorough medical evaluation, including an esophagogastroduodenoscopy (EGD) or upper endoscopy. This procedure allows a doctor to visually inspect the esophagus and stomach for any abnormalities, such as inflammation, strictures, or other issues that may be contributing to your symptoms.

6. Follow-Up with Specialists: Since your symptoms are multifaceted, consider consulting both a gastroenterologist for your esophageal symptoms and a mental health professional for your anxiety. A multidisciplinary approach may provide the best outcomes.

Conclusion
Your symptoms of thick saliva and a foreign sensation in the esophagus are likely interconnected and may be influenced by a combination of factors, including hydration status, GERD, anxiety, and your previous history of eating disorders. It is essential to address both the physical and psychological aspects of your condition. By working closely with your healthcare providers and possibly undergoing further evaluations, you can develop a comprehensive treatment plan that addresses all facets of your health. Remember, you are not alone in this, and seeking help is a crucial step toward feeling better.

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