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Senior member
Apr 27, 2007
Recently, I have been having bouts of my saliva going down the larynx and eliciting the cough reflex. This happens for no particular reason and I am not certain of the cause. I presume it could be due to tongue atrophy and the tongue mass no longer able to maintain saliva in the mouth cavity. I suppose it could also be an enhanced gag reflex, or some other cause. I have read that other PALS with bulbar symptoms experience the same situation. In addition, I am now having frequent post-nasal drip and I have to clear my throat constantly. This will not work for me as I am lecturing to my classes, so I need to find some remedy. Any suggestions? Thanks.
My grandmother has bulbar. She gets a prescription that helps with the salava. She also spits in a cup a lot. They have a machine kinda like the dentist uses that you can get to suck out the spit build up.
nasal drip

My ALS was bulbar onset also, and I have had most of the things you discribe. The trouble that I have now is a general, "stuffyness" , of the nasal passages during the day, and running nose and coughing while I'm eating.
My ENT Dr. gave me Nasacort AQ to use at bedtime, and it keeps me clear at night while I'm on the Bi-pap.
My Pulmanary Dr. gave me Ipratropium Bromide to use at meals, and it helps a little.
These are both nasal sprays.
I had the other Sx, but they seem to have gone away for now. I never did drool very much, just a little moisture at the left corner of my mouth. Just enough to make me keep wiping all the time !
Affrin will keep my nasal passages dry and open for 8- 12 hours, but the directions say not to use it for more than 3 days at a time.
Don't know what else to tell you, except to ask your Dr.s for something.
Good luck.
When that happens to me, people always assume I am chocking on something. They want to run around and get water for me. I tell them, through the coughing, that I am chocking. Then I wait for them to ask, "on what?" This is where I deliver my punch line, "AIR!"

BTW, that line works for tripping, also. Question: "Did you trip?"
Answer: "yes."
Question: "On what?"
Answer: "Air."
Thank you for your suggestions. Reacree, how long have you been diagnosed? Does anyone know why PALS have excess phlegm?


Your turning into another Al! Well, sometimes it is better to laugh then to cry.
My husband has been complaining about his mouth tasting so bad. He uses mouthwash a couple times a day. I don't know if thats a good thing or not. My husbands surgeon noted the amount of saliva in his mouth 2 visits ago. I'm assuming that my husband isn't receiving the message to swallow?

It's possible. So much of what normally happens without conscious control, such as swallowing, is disturbed in ALS. It may also be the case that people with ALS produce more saliva.

I was Dx in Jan. 2006 after 1 1/2 years of the testing routine. I seem to be progressing fairly slow, but not slow enough. lol. I can still walk some with the aid of a walker. Still can swallow, but chewing is just about a thing of the past. I have trouble with liquids and have to use a straw to drink. ( except coffee ) My lips will not close tightly, and liquids will run out if I'm not very careful. For the coffee I just cover my chest with a towel, take small sips and let her dribble ! Can't stand coffee with a straw ! Of course this means no coffee except at home.
Thanks for listening,
Hi guys. Seeing as someone mentioned my name I'll jump in. From what I understand (subject to debate) we don't actually produce that much more saliva/ phlem but we lose the function to swallow it normally. Think of taking a sip or a gulp of water. If you don't or can't swallow it, where's it going? Down the front of your shirt. I don't have bulbar symptoms yet? but a couple of times a week some saliva slips down my throat and chokes the heck out of me. Saliva? Why? Food doesn't choke me. ?
Al, this must be what is happening to me. The swallowing mechanism is a very fine tuned system and when one aspect of the system starts to degenerate, then we start to experience problems. I suppose solid food can be compacted and swallowed more effectively, while liquids can go anywhere and possibly into the larynx.


Thanks for sharing. That means you had symptoms back in '04, but like most everyone else here, it takes a couple of years for a diagnosis, it seems.
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