I have started to choke spontaneously on my own saliva. Anyone else?

Posted by chinasvegas @chinasvegas, Apr 19, 2022

I’m a 75 year old female take no medication and have had no diagnosis. Lately I’m chocking on my own saliva occasionally. The kind of chocking that used to happen only when liquid goes down the wrong way. Now it seems that I spontaneously choke on my own saliva. Anyone have this experience?

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@brandysparks

I have GERD and take Omeprazole, but it doesn't help this condition of constant drainage, occasional coughing fits, congestion (for decades) and, lately, this out-of-the-blue choking and/or increased super-sensitivity to things going down my throat, possibly even going down - or just FEELING like they're going down - the wrong way.

I tried to treat allergies to dust, old, mildew, pollen decades ago when I moved from the east coast to Texas, but the allergy doctor's prescription for shots didn't make a difference, and I quit those after a year.

HOWEVER, I did just come across this mention on the Washington Post website, and if you can't link to it via this without a subscription, I think you can still sign up to check/search topics without a subscription. But there must be other articles on it - maybe even here on the Mayo Clinic website:
________________________________

https://www.washingtonpost.com/wellness/2023/11/07/lpr-hoarseness-throat-clearing-reflux/

[aka "laryngopharyngeal reflux"]

"Frequently overlooked, ‘silent reflux’ is treatable once diagnosed
By Janice Neumann
November 7, 2023 at 5:30 a.m. EST
___________________________________

I hope this might help at least some. I'm going to bring it up with my new doctor I'm meeting for the 1st time this Tuesday - after my PCP of many years 'up and retired' with nothing but a "10-day notice" from his office.

Best to everyone.

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Thank you for this information. I too am going thru the same this. Will check it out.

Karina

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I was wondering if a barium swallowing test has been done to visualise the epiglottis action?
And if sensory responsiveness to stimuli is intact at the base of the tongue and soft palate to initiate the process of swallowing?

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@mguspixi25

I was wondering if a barium swallowing test has been done to visualise the epiglottis action?
And if sensory responsiveness to stimuli is intact at the base of the tongue and soft palate to initiate the process of swallowing?

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Yes, I had a barium swallow years ago - that confirmed I had reflux up to the level of my collar bone. Started omeprazole.

It continues, and as I now have a new doctor, we are going to schedule an endoscopy to check in on the situation.

I also - for over 4 years or so - have found I need to take constant breaks to breath / swallow when at a normal dentist's appointment, which I am sure to share with the dentist before we start. Having my neck back in the "holder" on the dentist's chair seems to restrict my throat, and I start to feel as if I may choke. Am adding that into my Qs with the new ENT I hope to meet soon, after getting a referral from my new PCP.

This constant (& I mean for over 20+ years) drainage must have an impact on many things - including my GI tract (have IBS), increasingly getting sinus pressure issues, headaches, and wondering if it created - or, at least contributed to - the moderate sleep apnea I have had for 15+ years as well.

Hoping to get answers, though it also seems more difficult to get through the system to get these answers, and even then, I want to be cautious about not "over-treating", "over-medicating", and other invasive procedures that could cause more harm than good.

Guess a lot of this comes down to having trust and genuine listening and communication with the providers we seek out.

Best to all here!

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@brandysparks

Yes, I had a barium swallow years ago - that confirmed I had reflux up to the level of my collar bone. Started omeprazole.

It continues, and as I now have a new doctor, we are going to schedule an endoscopy to check in on the situation.

I also - for over 4 years or so - have found I need to take constant breaks to breath / swallow when at a normal dentist's appointment, which I am sure to share with the dentist before we start. Having my neck back in the "holder" on the dentist's chair seems to restrict my throat, and I start to feel as if I may choke. Am adding that into my Qs with the new ENT I hope to meet soon, after getting a referral from my new PCP.

This constant (& I mean for over 20+ years) drainage must have an impact on many things - including my GI tract (have IBS), increasingly getting sinus pressure issues, headaches, and wondering if it created - or, at least contributed to - the moderate sleep apnea I have had for 15+ years as well.

Hoping to get answers, though it also seems more difficult to get through the system to get these answers, and even then, I want to be cautious about not "over-treating", "over-medicating", and other invasive procedures that could cause more harm than good.

Guess a lot of this comes down to having trust and genuine listening and communication with the providers we seek out.

Best to all here!

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The endoscopy sounds like a really good idea - I hope the medics can treat if they find anything unusual 🙂
The symptoms seem unusual that you describe, and Im no doc or medical person (I am trained in allied health), however I wondered if it is worth asking about neurological origins, like nerve root compression in your neck or some other peripheral nerve issue like autonomic neuropathy?
I was formerly a sleep tech (the person who did the overnight sleep studies and reported the findings back to the pulmonologist/cardiologist) and there was always a wide array of sinus, throat, and symptomatology (including headaches) that I would record in the interview prior to testing or titration (where I would see what pressures and types of air delivery were needed for a person to maintain airway patency and adequate SpO2), which I would then contrast with morning findings using the same interview and score, to which I would provide specialists.
I dont know if you have done a recent (high quality) sleep study and if not, if it is worth undertaking, along with a head CT or some sort of investigation to image your areas that are causing problems? I can say that in the years I was working as a sleep tech, I saw a circular influence of sinus/other issues contributing to obstructive/mixed sleep apnoea, which would then exacerbate the sinus/other issues...all getting more symptomatic and disruptive over time (and the requirement to help was an intervention that broke the cycle, to start with, so to speak).
When it comes to managing multiple conditions that may or may not be linked, all being managed by different specialists that can remain siloed in their specialty at times, it falls on the patient themselves to work out the best form of care and the pathway to follow to get there.
I used to make a chart with the issues/medical problems across the top, and list the symptoms underneath each that may be related to it/occur due to it, and then see which ones were common. I then would grade them in terms of impact or loss of function, therefore which were priorities to treat. Then, I would see which medical problem had the most impactful symptoms, and which symptoms I should try to address first. By knowing which medical condition, I could then approach the correct specialist, in terms of priority and symptomatology of greatest concern.
I hope that might be helpful?
I wish you all the best, and I hope your medics can work together to figure out the root cause of this issue for you 🙂

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@chinasvegas

Hello and thanks so much. I would never have thought of a speech therapist. What a great idea. I will let you know how it goes. Thank you. 🙏🏼

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It’s swallow therapy not speech. Sorry if I misled.

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@chinasvegas

That is truly scary. Thanks so much for your insight. My symptoms are not severe just have that coughing that we all do across our lives if something goes down the wrong way. With age and across the past year or so it is much more spontaneous and just happens with saliva and not when drinking as before. I will get it diagnosed and hope for the best. Thanks you.

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My symptoms exactly like yours. It’s not often that I choke on my own saliva just once in a while now. I hardly ever choke when eating meaning something goes down the wrong way. Just that spontaneous chocking on my own saliva. Very annoying especially when people are still Covid sensitive. I usually have water around alas sipping usually stops it right away.

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@mguspixi25

The endoscopy sounds like a really good idea - I hope the medics can treat if they find anything unusual 🙂
The symptoms seem unusual that you describe, and Im no doc or medical person (I am trained in allied health), however I wondered if it is worth asking about neurological origins, like nerve root compression in your neck or some other peripheral nerve issue like autonomic neuropathy?
I was formerly a sleep tech (the person who did the overnight sleep studies and reported the findings back to the pulmonologist/cardiologist) and there was always a wide array of sinus, throat, and symptomatology (including headaches) that I would record in the interview prior to testing or titration (where I would see what pressures and types of air delivery were needed for a person to maintain airway patency and adequate SpO2), which I would then contrast with morning findings using the same interview and score, to which I would provide specialists.
I dont know if you have done a recent (high quality) sleep study and if not, if it is worth undertaking, along with a head CT or some sort of investigation to image your areas that are causing problems? I can say that in the years I was working as a sleep tech, I saw a circular influence of sinus/other issues contributing to obstructive/mixed sleep apnoea, which would then exacerbate the sinus/other issues...all getting more symptomatic and disruptive over time (and the requirement to help was an intervention that broke the cycle, to start with, so to speak).
When it comes to managing multiple conditions that may or may not be linked, all being managed by different specialists that can remain siloed in their specialty at times, it falls on the patient themselves to work out the best form of care and the pathway to follow to get there.
I used to make a chart with the issues/medical problems across the top, and list the symptoms underneath each that may be related to it/occur due to it, and then see which ones were common. I then would grade them in terms of impact or loss of function, therefore which were priorities to treat. Then, I would see which medical problem had the most impactful symptoms, and which symptoms I should try to address first. By knowing which medical condition, I could then approach the correct specialist, in terms of priority and symptomatology of greatest concern.
I hope that might be helpful?
I wish you all the best, and I hope your medics can work together to figure out the root cause of this issue for you 🙂

Jump to this post

Thank you so much - this is especially helpful, and I really appreciate the detail you went into, especially about the sleep studies.

I've done 2 - 3 of them over a period of 15+ years, and they confirmed I have moderate sleep apnea, but I must say I never felt there was much attention paid to the details you have shared... particularly regarding other contributing symptoms or dynamics. I've tried the CPAP, but cannot endure it on any prolonged basis, so I've considered Inspire, and read about other methods, but that's for another Mayo Clinic Connect discussion thread, which I have participated in. So, "TBD".

I wish I could take you along on my journey to share these kinds of insights! - it seems I'm doing all of the investigating and tying together - where it seems warranted - and yet nothing is specifically resolved or addressed.

We've discussed this in another thread, but it really feels like the patient - with all due respect to the highly credentialed medical professionals - must do the due diligence, and then the burden falls in our laps to make sense of it all - the professionals and the system they must work within has made it consistently difficult, if not impossible, to have the time and attention paid to the individual patient to make effective use of the advances that R & D has provided.

Ah, well. Been delayed in responding to your post, but have kept it open since you posted it so I could convey my appreciation - Again: thank you.

I hope your journey is rewarding and fulfilling. Welcome your thoughts, insights any time.

Best wishes.

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@brandysparks

Thank you so much - this is especially helpful, and I really appreciate the detail you went into, especially about the sleep studies.

I've done 2 - 3 of them over a period of 15+ years, and they confirmed I have moderate sleep apnea, but I must say I never felt there was much attention paid to the details you have shared... particularly regarding other contributing symptoms or dynamics. I've tried the CPAP, but cannot endure it on any prolonged basis, so I've considered Inspire, and read about other methods, but that's for another Mayo Clinic Connect discussion thread, which I have participated in. So, "TBD".

I wish I could take you along on my journey to share these kinds of insights! - it seems I'm doing all of the investigating and tying together - where it seems warranted - and yet nothing is specifically resolved or addressed.

We've discussed this in another thread, but it really feels like the patient - with all due respect to the highly credentialed medical professionals - must do the due diligence, and then the burden falls in our laps to make sense of it all - the professionals and the system they must work within has made it consistently difficult, if not impossible, to have the time and attention paid to the individual patient to make effective use of the advances that R & D has provided.

Ah, well. Been delayed in responding to your post, but have kept it open since you posted it so I could convey my appreciation - Again: thank you.

I hope your journey is rewarding and fulfilling. Welcome your thoughts, insights any time.

Best wishes.

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No worries - happy to hear it was helpful 🙂🌺
Hmm, reading that you’ve had multiple sleep studies and been prescribed CPAP however it has not been successful highlights that there is some form of ‘failure to find the problem’ either in the sleep studies or by the physicians… diagnostic studies show apnoea - yes - however, they do not necessarily demonstrate positively whether it’s OBSTRUCTIVE, MIXED, or CLEAR AIRWAY/CENTRAL apnoea.
This happens when a secondary diagnostic study is done using more specialised testing equipment (not usually used in standard diagnostic tests), or during a titration study with excellent active monitoring by the sleep technician whom is controlling the device delivering the titrated pressure/s (pressures = the requirement if IPAP and EPAP when testing if someone has clear airway/central sleep apnoea). For instance, if it seemed the patient I was titrating was not stabilising on just singular pressure delivery (APAP or CPAP), and showed disturbance to their brain waves, SpO2, heart rate/EKG, etc, I would flick the machine into bi level delivery and titrated as if they have mixed or clear airway needs (this means their airway is NOT physically obstructing; instead, their airway remains OPEN, BUT, for some other reason, they are unable to ventilate enough VOLUME OF AIR to adequately exchange gases in their alveoli - they aren’t moving air in and out - so, I flick over to trying many forms of ventilation which is designed to move air in and out, instead of staying on singular delivery of CPAP/APAP which is only designed to splint the airway open so it doesn’t flip closed - the person still must have the ability to VENTILATE/breathe enough air in and out on their own, for CPAP/APAP to work, and thus be ‘comfortable’ and ‘useable’ overnight).
Ok, having said that, Inspire device would work excellently if the person only had physical obstruction of their upper airway as their problem; but if there is a problem moving air in and out (failure to adequately ventilate with or without upper airway obstruction) this device would not be the appropriate device to fix the problem. If a person didn’t titrate onto CPAP while watching all their other parameters for normalcy, I used non invasive ventilation (a form of IPAP/EPAP), and titrated/monitored. If they then were falling into normal sleep patterns per their other signs being monitored, then I would write this up as significant findings to the pulmonologist or cardiologist to consider when integrating sleep management for safe oxygenation and appropriate sleep treatment.
Some people who could not get comfortable on CPAP would have a study with me, and if I found CPAP wasn’t suited, I would trial them on bilevel delivery, which almost always became second nature to their nighttime breathing - simply because it was treating their problem, not working against them and their breathing needs - which is what happens when a person is using the wrong breathing equipment, resulting in them never being able to get used to it (which is pretty obvious once you know). In terms of implantable devices for clear airway apnoea (failure to adequately ventilate the lungs), one that comes to mind is the diaphragm stimulator - stimulating the muscle to contract and thus make a person take a breath. There are various brands for different purposes, however it is surgery, and like all surgery there are risks and limitations of efficacy (just like there are risks and limitations of efficacy in non-invasive bilevel delivery too, depending on the condition of the person and any other lung disease that may be there - sometimes bi level is contraindicated in particular lung tissue disease).
Ok, I hope that helps clarify why sometimes CPAP isn’t efficient and effective? Sorry it’s a long one, but it helps I think, to explain it comprehensively 🙂
You’re very right in that medical systems and professionals do not have the structures of service delivery in place to give decent comprehensive and connected-to-other-specialists-care, and so it leaves all the work to the patient, who is already burdened with illness, to have the time and energy to figure out what is going on and ‘lead’ flexible specialists to potential options, so that they can then use their knowledge of disease to narrow down the potential sources of illness. It’s taken me years to find practitioners that are willing to hear out my theories, using printed out research/scientific findings, to them. But, when they see my clinical reasoning, they then can say whether it might be, or that it’s not possible and we should look elsewhere. I am the specialist in my symptoms and their impact/severity/combinations, and using a chart as described in my previous post, I can categorise them. The doc is the specialist in how diseases manifest, so I try to put the two together to get the best outcomes. It’s different to going to a specialist and expecting answers; it’s taking a logical pattern to them to enable them to follow deductive logic in disease patterns and likelihoods - making it easier to figure out what might be happening. If they don’t like my methods and are dismissive, I then know they are the docs not interested in treating disease, but perpetuating it for the sake of an income, and I move on to someone who is in medicine to get patients out of it 🌺🙂
All the very best 😀

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This has happened to me at times too. Especially related to exhaust from traffic. Like it’s irritating me in some way at times. I know the American Heart Association has mentioned that air pollution is one of the causes of heart attacks so this makes sense with coughing so much that it’s a strain on one’s heart.

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I have the same issue. I believe it comes with aging in part. It’s an issue with the swallowing mechanism where part of it may stop working.
Also-smoking cigarettes a number of years causes this issue . I quit 4 years ago and still have the swallowing issue. I would see a doctor-mine got progressively worse so I wouldn’t wait.
Hope this helps
-Retha

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