Nasal and Salivary Issues in Stroke Patients

Nasal and salivary issues?

Hello, Dr.
Chi,
I am inquiring on behalf of my grandfather regarding his symptoms.
In recent days, he has been experiencing continuous clear nasal discharge and excessive saliva secretion, which he has been spitting out.
He does not have any phlegm in his throat.
Currently, my grandfather is a stroke patient (due to microvascular obstruction in the brain) and has paralysis on one side of his body, making him unable to walk independently, but he is still able to engage in conversation.

I would like to ask about my grandfather's possible condition and how we can further confirm it or what kind of assistance we should seek.
Since my grandfather has not received the COVID-19 vaccine and is older with a weaker immune system, we prefer to avoid going to the hospital unless absolutely necessary.
However, if you determine that his condition requires immediate medical attention, we will take him to the hospital right away.
Thank you!

Mr. Chen, 70~79 year old female. Ask Date: 2022/05/10

Dr. Ji Zhaoyun reply Otolaryngology

Hello, it could be a case of general nasal allergies, but infections and other conditions cannot be ruled out.
I recommend that you look for clinics or hospitals that offer telemedicine consultations for assistance.
Wishing you good health and safety.

Reply Date: 2022/05/10

More Info

Dear Patient,
Thank you for reaching out regarding your grandfather's recent symptoms. Understanding the interplay between nasal and salivary issues in stroke patients is crucial, especially given your grandfather's medical history of a stroke due to microvascular obstruction.
Firstly, the symptoms your grandfather is experiencing—persistent clear nasal discharge and excessive salivation—can be indicative of several underlying issues. In stroke patients, particularly those with neurological deficits, changes in autonomic nervous system function can lead to altered secretions. This may manifest as increased salivation or nasal discharge.
1. Nasal Discharge: The clear nasal discharge could be due to several factors:
- Allergic Rhinitis: Given the clear nature of the discharge, it could be related to allergies, especially if there are environmental triggers (like dust or pollen) in the home.

- Post-Nasal Drip: This occurs when mucus accumulates in the back of the throat, leading to a sensation of nasal congestion and potentially contributing to the nasal discharge.

- Infection: Although the discharge is clear, it’s essential to consider that infections (viral or bacterial) can also present with similar symptoms.
2. Excessive Salivation: Increased salivation can occur in stroke patients due to:
- Neurological Changes: The stroke may have affected the areas of the brain responsible for controlling salivary glands, leading to dysregulation.

- Difficulty Swallowing: If your grandfather has difficulty swallowing (dysphagia), it may lead to pooling of saliva in the mouth, resulting in excessive drooling.

- Medications: If he is on any medications, some can have side effects that include increased salivation.

Given your grandfather's age and medical history, it is essential to monitor these symptoms closely. Here are some recommendations:
- Consult a Healthcare Professional: While you mentioned a reluctance to visit the hospital, it is crucial to consult a healthcare provider, especially if the symptoms persist or worsen. A neurologist or an ear, nose, and throat (ENT) specialist would be appropriate for evaluating these symptoms.

- Home Care: In the meantime, ensure that your grandfather is comfortable. Keeping the environment humidified can help with nasal discharge. Encourage him to stay hydrated, as this can help manage salivation.

- Monitor for Other Symptoms: Keep an eye out for any additional symptoms such as fever, changes in consciousness, increased weakness, or difficulty breathing, which would necessitate immediate medical attention.

- Vaccination: While you mentioned that he has not received the COVID-19 vaccine, it is essential to discuss vaccination with his healthcare provider, especially considering his age and health status.

In conclusion, while the symptoms may not seem severe at first glance, they warrant a thorough evaluation to rule out any complications related to his stroke or other underlying conditions. If you notice any sudden changes in his condition, do not hesitate to seek immediate medical assistance.
Wishing your grandfather a swift resolution to his symptoms and improved health.

Best regards.

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