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December 28, 1984

A 'Supersalivation Syndrome'

JAMA. 1984;252(24):3363. doi:10.1001/jama.1984.03350240013007

To the Editor.—  For about ten years I have had an esophageal reflux syndrome characterized by recurrent epigastric distress, "heartburn," and awakening at night with sour regurgitation and rather severe epigastric pain. The pain, also sometimes present in the lower retrosternal area, feels like a spasm. What has been striking, however, is the remarkable, exuberant outpouring of saliva that occurs with the pain. They go together when the pain is more severe; milder pains may not be associated with the salivary hyperfunction. When it occurs, the salivary outpouring forces almost continuous swallowing and at times is itself more disconcerting than the pain.The epigastric and lower retrosternal pain is relieved by sitting up and drinking hot water or by sucking on an antacid tablet. Even the severe pain is relieved in a few minutes, although a vague residual discomfort may persist for up to 30 minutes. All the symptoms are