What is Ptyalism?Shannon McKelden
What is Ptyalism?
Though it has a funny name, ptyalism (ti´ah-lizm) is simply an excess production of saliva. As a symptom of pregnancy it occurs frequently in women who are suffering from nausea or morning sickness and seems to occur most often during the first 12 weeks of pregnancy.
“Most authorities believe ptyalism actually represents inability of the nauseated woman to swallow normal amounts of saliva rather than a true increase in the production of saliva,” says Dr. Jorge Pando, an OB-GYN with Palmetto General Hospital in Hialeah, Florida.
“When I was pregnant with my first daughter five years ago, especially at the beginning of the pregnancy, I found myself constantly ‘spitting’ at co-workers in conversations,” says Karen* of Youngstown, New York. “I didn’t realize at the time that it was connected with being pregnant! It was only after I read about it as a ‘symptom’ later on that I said, ‘ah ha, well that explains it!'”
Causes and Duration
Increased salivation can be related to heartburn, which is common during pregnancy. “The contents of your stomach are acidic, and when they back up on you, they irritate your esophagus and cause the burning sensation so familiar to heartburn sufferers,” Dr. Pando says. “The acid sensors in your esophagus then trigger your salivary glands to produce saliva that has an increased concentration of bicarbonate, which is alkaline.”
As with morning sickness, ptyalism seems to be most common early in pregnancy. But, also like morning sickness, that’s variable among women. For Dorothy Leland of Davis, Califorinia, the ptyalism lasted about six weeks. “Then it was gone as suddenly as it had started,” she says. “I asked my doctor about it, and he said that it was not uncommon in pregnancy, and had to do with hormones.”
However, Arlinda McIntosh found that the excess saliva production occurred 24 hours a day. “[I had] not one hour without a cleverly decorated spittoon at home, a purse full of tissues when I went out, and a towel on my pillow,” says the Verona, New Jersey, resident, who found that the condition lasted six months with her first child, eight months with her second, and all nine months with her last.
Can It Cause Complications?
Thankfully, ptyalism is a fairly benign symptom when associated with pregnancy. It isn’t a sign of a more serious problem, and it isn’t likely to cause harm to either the mother or baby.
“I was worried about it when I first started to notice it,” says Amy Oztan of Brooklyn, New York. “But thank goodness for the Internet. I looked it up and found that it was very common in pregnant women.”
Oztan mentioned it to her physician, who confirmed what she’d read on the Internet and told her not to worry, though the symptoms were annoying. “I was very aware of it for a few months,” she says. “It made me feel like I was going to throw up, even though being pregnant wasn’t making me nauseous.”
However, depending on the severity, ptyalism can cause a loss of one to two liters of saliva a day. “As much as two quarts of saliva has been collected in a day from one case, making dehydration a possible condition associated with excessive saliva production,” Dr. Pando says. “To prevent dehydration women should drink plenty of fluids as well as to swallow as much saliva as possible.”
Coping with Ptyalism
It is recommended that you speak to your caregiver about this condition so he or she can try to help you relieve any underlying condition that may be contributing to the problem, like nausea, vomiting, or heartburn. “Talk to your doctor about different medications you can try,” Dr. Pando says. “If you smoke cigarettes this could be the reason, [so] ask your doctor for a referral to a smoking cessation program.”
Dr. Pando reports that some women find the following measures helpful:
- Eat frequent, small meals and avoid excessive amounts of starchy food.
- Drink plenty of water. Take frequent small sips. This will make it easier for you to swallow the saliva you do produce.
- Try munching on crackers before getting out of bed, eating every two hours, and having a high-protein snack before bedtime.
Other tricks may include sucking on hard candies (maybe peppermint, which could also help with any nausea) to make swallowing the saliva more palatable.
Laura Laing of Baltimore, Maryland, came up with a trick that worked for her. “I discovered cinnamon gum!” she says. “When I had that gum in my mouth, I felt normal. I went through about a pack a day. I even kept it by my bed, so that I could pop some in my mouth in the middle of the night. I was just praying that I wouldn’t end up with the red goo in my hair in the morning.”
Others found it necessary to carry around tissue or even small cups in which to spit. “Purchase a little powdered drink mix can (keep the top, you’ll need it), empty, decorate, and add a few Kleenexes—instant decorator spittoon,” McIntosh says.
Most of all, don’t stress about this condition. Dr. Pando reminds moms that the most important thing is to remember that ptyalism has no adverse effect on pregnancy and the condition generally subsides after the first trimester.
* Last name withheld to protect privacy.