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DIETARY MANAGEMENT STRATEGIES FOR SELECTED NON-SPECIFIC

NUTRITIONAL FEEDING PROBLEMS

INTRODUCTION
Saliva is the key ingredient in food digestion, and helps protect teeth from decay, prevents
infection, and makes chewing and swallowing possible. Without saliva we wouldnt be able to
break down food for proper digestion or wash away food and debris afterward. Saliva is one
of the best indicators of health, as it maintains balance in the body, so if something is off
theres a good chance your saliva has changed as a direct reflection. Spit screening can
expose an array of biological secrets to doctors with just half of an eyedropper worth of spit.
By just screening for a specific protein, doctors have the ability to assess heart disease risk.
Saliva is a watery substance formed in the mouths of humans and animals, secreted by
the salivary glands. Human saliva comprises 99.5% mostly water plus electrolytes, mucus,
white blood cells, epithelial cells (which can be used to extract DNA) glycoproteins,
enzymes (such as amylase), antimicrobial agents such as secretory IgA and lysozyme. The
enzymes found in saliva are essential in beginning the process of digestion of dietary starches
and fats. These enzymes also play a role in breaking down food particles entrapped within
dental crevices, thus protecting teeth from bacterial decay. Furthermore, saliva serves a
lubricative function, wetting food and permitting the initiation of swallowing, and protecting the
mucosal surfaces of the oral cavity from desiccation. Various animal species have special
uses for saliva that go beyond pre-digestion. Some swifts use their gummy saliva to build
nests. Aerodramus nests form the basis of bird's nest soup. Cobras, vipers, and certain other
members of the venom clade hunt with venomous saliva injected by fangs. Some arthropods,
such as spiders and caterpillars, produce thread from salivary glands.

BODY
Did you know that it is not normal to get thick saliva? Thick saliva or mucous is described as
viscous, acidic, and semi-opaque secretion as opposed to clear, watery and neutral
secretions. This change in saliva is due to the presence of abnormally large quantities of
organic material in saliva, which may contribute to dysphagia, nausea, vomiting and/or poor
oral intake. The onset and duration of thick saliva depends on the cause and the tumor site.
This suggest some inflammation in the upper respiratory tract, sinuses, or the oral activity.
Normal saliva is an essential secretion produced by the salivary glands inside our oral cavity.
We produce around 1-2 liters of this mucoid secretion everyday. It has many uses, it acts as a
lubricating fluid while we eat and talk. It is anti-bacterial and destroys many bacteria entering
our mouth. Apart from this, it has few enzymes that aid in the digestion of food. Normally, it
has a thin non-disturbing consistency. It is absolutely non-irritating and alkaline in nature. Any
variation from this normal form indicates an illness.
And this is are the common causes of getting a thick or stringy saliva:
Dehydration
May contribute to thickened secretions. Water is a major component of saliva. If you are
drinking less water than required, it is possible that you may get relatively thick salivary
secretions. You may notice that you urine is also concentrated and darker in color. So if you
have no other complaint besides having a thick sputum that tends to stick in the throat, you
may just need to take more water.

Smoking
Smoking irritates the internal lining of the upper respiratory tract. This leads to increased
mucus production in the upper airways. Smokers often feel that something is sticking in their
throat. They may continuously try to swallow it down. They may also experience some cough
with mucoid secretions.
Chronic Sinusitis
Patients with chronic sinus problems often complain of thick phlegm and bad breath. It
happens because the sinuses keep producing mucus, which continuously drains into the
mouth and backwards into the throat. This is called post nasal drip and leads to thickening of
sputum. Patients have a tendency to pull the sticky phlegm from their throat into the mouth
and spit it out. It may also be accompanied by other symptoms like low grade fever or
headache.
If you have any sinus problems, then you need to go to an ENT specialist and get treatment.
Candidiasis
Another reason can be candidiasis in the oral cavity. Check for any white patch inside your
mouth. If yes, you may be infested with a fungus called Candida.
Candidiasis requires treatment with antifungal medicines. All sugars and carbohydrate diets
need to be limited. Also, good oral hygiene is required during treatment.
Cold and Cough
Do you have any cough or cold-like symptoms? When a person has flu or any other
respiratory infection in which mucoid secretions are produced, the thick mucus may mix with
salivary secretions to make them viscous and sticky. In such situations, the respiratory
disease needs to be treated.
Autoimmune Disorders
A rare cause could be some autoimmune disorder like Sjogrens syndrome. You may get a
blood test done to exclude this cause.
Seasonal Allergies
If you are getting a thick stringy phlegm only during some particular months of the year, it may
be a seasonal allergic reaction. During months when seasons change, like April or
September, a number of pollens are seen in the air.
Many people are allergic to them. Some get rashes on their skin, some sneeze and others
may just note a thickening of their phlegm.

You just need to take an over-the-counter anti-allergic medication for a week.


Medications
There are certain medicines that tend to dehydrate the oral cavity. This leads to thickening of
the sputum. They include certain antidepressants, antihistamines and decongestants.
Diabetes and Other States of Elevated Blood Sugar
Uncontrolled sugar levels in the blood is associated with dry mouth and a feel of thick sputum.
This happens in untreated diabetes, pregnancy and other hyperglycemic states.
Gastroenteritis
People with no other upper ENT problem need to watch their tummy. Do you have any gastric
problem such as acidity or frequent bloating?
Any form of gastroenteritis may affect the consistency of sputum.
GERD
Gastroesophageal reflux disease is a condition, where acid produced in the stomach gets
back into the mouth. Mouth needs to produce extra salivary secretions to counteract the
acidic contents of the stomach.
This happens when the sphincter or the muscular gate between the esophagus and the
stomach becomes loose or inefficient.
Obese people or post-surgery cases are prone to such conditions
Management
It would be necessary to diagnose the underlying cause. Is it some infection, sinusitis, or
some other condition? The underlying disease needs to be treated. The saliva will normalize
gradually as you get the right treatment.
Some Helpful Self Care Tips
Drink lot of water. This will help in thinning of the saliva. The sticky feeling in your throat will
also reduce thereby. If possible, let it be a lukewarm water.
Avoid smoking. It leads to a production of thick mucus that mixes with saliva to make it viscid.
Maintain a good oral hygiene. Thick saliva is usually acidic and may damage your teeth. So
you need to brush your teeth and rinse your mouth with plain water more often.
Gargle regularly with warm water and a pinch of salt mixed in it. This will dislodge any thick
mucus sticking in the throat.

Include yogurt in your diet. It will help in normalizing the flora in your mouth.
Avoid taking too much of dairy products like milk, cheese or fat. Such foodstuffs aid in mucus
production.
Consume plenty of whole grains, fresh seasonal fruits and vegetables. They lessen mucus
production in the body.
You may take vitamin C and E supplements for some time. Along with water, they are good
for clearing up the throat mucus.
Drink hot beverages like vegetable soups and herbal teas, which moisten your airways. Avoid
too much of coffee and tea, which are dehydrating in nature.
Inhale steam from a tub of boiling water to moisten your airways. You may pour a few drops
of eucalyptus oil in the tub. This would also soothe the inflamed lining of the throat mucosa.
Use a humidifier or a mystifier in your bedroom at bedtime.
Avoid exposure to dust, road pollution or cleansing chemicals.

CONCLUSION
According to my research, thick viscous saliva is not normal and easy situation that suggest
some inflammation in the upper respiratory tract, sinuses, or the oral activity. And when youre
are stressed, salivary glands secrete an enzyme into the mouth known as salivary alphaamylase and doctors can use it to gauge the amount of stress a mother places on her unborn
babe. Conversely, if a females saliva contains abnormally low cortisol levels in the morning
and high levels whenever she discusses stressful events or anxieties, theres a good chance
she doesnt have a strong relationship with her father. Researchers found the imbalance of
cortisol, the stress hormone, indicates emotional sensitivity to stressful situations.
Not only does it harbor 72 different types of bacteria, its also one of the most powerful
painkillers thanks to the opiorphin it contains. Opiorphin is six times stronger than morphine
and helps stop enkephalin pain signals from reaching the brain when the body undergoes an
extreme amount of pain to maintain balance, according to the journal of Nature. Saliva is
produced around the clock and is affected from every bite of food you take, to every stressful
situation you find yourself in. Theres a lot saliva can tell about a persons health, especially
since the salivary glands produce two to four pints of it every day.

BIBLIOGRAPHY
References: http://www.bccancer.bc.ca/nutrition-site/Documents/ThickSaliva.pdf
http://www.buddymd.com/thick-saliva-sticks-throat

INTRODUCTION
Esophagitis is any inflammation or irritation of the esophagus. The esophagus is the tube that
sends food from your throat down to your stomach. Common causes include acid reflux, side
effects of certain medications, and bacterial or viral infections. Reflux is when the stomach
contents and acids back up into the esophagus.
This disorder can cause a wide variety of symptoms, including trouble swallowing, sore
throat, and heartburn. Untreated esophagitis can lead to ulcers or even to a severe
narrowing of the esophagus, which can be a medical emergency.
Your treatment options and outlook depend on the exact cause of your condition. Most
healthy people improve, with proper treatment, within two to four weeks. Recovery may take
longer for people with a weakened immune system or infection.

BODY
Did you know that Esophagitis or Oesophagitis is may be acute or chronic? Acute
esophagitis can be Catarrhal or Phlegmonous where as chronic esophagitis may be
hypertrophic or atrophic.
Types of Esophagitis

Eosinophilic esophagitis is the result of too many white blood cells in the esophagus. This is
the result of your body over-responding to an allergen. In children, this allergic reaction can
make it difficult to eat. According to the Boston Childrens Hospital, 1 in every 10,000 children
has this form of esophagitis. Common triggers include milk, soy, eggs, rye, wheat, peanuts,
beans, and beef. Inhaled allergens, such as pollen, can also cause this form of esophagitis.
Reflux esophagitis is usually due to a condition known as gastroesophageal reflux disease
(GERD) GERD is when the stomach contents, including acids, frequently back up into the
esophagus. This causes chronic inflammation and irritation of the esophagus
Drug-induced esophagitis can occur when you take certain medications with insufficient
water. This causes them to linger in the esophagus too long. Medications may include pain

relievers, antibiotics, potassium chloride, and bisphosphonates (drugs that prevent bone
loss).
Infectious esophagitis is rare and can be due to bacteria, viruses, fungi, or parasites. You are
at increased risk for this type of esophagitis if you have a weakened immune system due to
disease and/or medications. This type of inflammation is common in people with HIV or
AIDS, cancer, and diabetes.
Symptoms of Esophagitis

Symptoms of esophagitis include:

Difficulty swallowing (dysphagia)

Pain when you swallow (odynophagia)

Sore throat

Hoarse voice

Heartburn

Acid reflux

Chest pain (worse with eating)

Nausea

Vomiting

Abdominal pain

Decrease in appetite

Cough
Very young children may have difficulty feeding.
Contact your doctor if you or your child experience this, and:

you also have shortness of breath or chest pain, especially if it does not occur while
eating

symptoms continue for more than a few days

symptoms are severe enough to interfere with your ability to eat properly

you also have headache, muscle aches, or fever


Seek immediate medical attention if:

you have chest pain lasting more than a few minutes, especially if you have a history
of heart problems, elevated blood pressure, or diabetes

you think you may have food stuck in your esophagus

you are unable to consume even small sips of water

Risk Factors for Esophagitis

Risk factors for developing esophagitis include:

weakened immune system due to HIV or AIDS, diabetes, leukemia, lymphoma, or other
autoimmune diseases

hiatal hernia (when the stomach pushes through the opening in the diaphragm between
the esophagus and stomach)

chemotherapy

radiation therapy of the chest

surgery in the chest area

medications to prevent organ transplant rejection

aspirin and anti-inflammatory medications

chronic vomiting

obesity

alcohol and cigarette use a family history of allergies or esophagitis

Your chance of developing an infection of the esophagus is low if you have a healthy immune
system.

Potential Long-Term Health Complications

Untreated esophagitis can lead to other, more serious health complications related to the
function and structure of the esophagus. Complications include:

Barretts esophagus, damage to your esophagus

stricture, or narrowing, of the esophagus that can lead to problems swallowing

holes or ulcers in the esophagus (esophageal perforation)

How Is Esophagitis Diagnosed?

Make an appointment to see your doctor if you have signs of esophagitis. Be prepared to
provide a full medical history, including any previously diagnosed conditions. List all of the
prescription and over-the-counter medications you take.
Your doctor will likely perform a physical examination. They may also order diagnostic tests,
including:

endoscopy

barium X-ray, also called an upper GI series

biopsies

allergy testing, which may include skin tests and eliminating certain foods from your
diet

Treatment for Esophagitis

Treatment depends on the specific cause of your symptoms. Medications may include:

antiviral medications

antifungal medications

antacids

pain relievers

oral steroids

proton pump inhibitors (these medications block stomach acid production)

If food allergies cause your condition, you must identify trigger foods and eliminate them from
your diet. Common food triggers include tomatoes, citrus fruits, spicy food, alcohol, caffeine,
onions, garlic, mint, and chocolate.
You can also ease your symptoms by avoiding spicy foods, acidic foods and drinks, and raw
or hard foods. Take smaller bites and chew your food well. You should avoid tobacco and
alcohol, which increase inflammation and suppress the immune system. Ask your doctor for
dietary guidelines.
Surgery to dilate the esophagus may be necessary if the esophagus has become too narrow
and causes food to lodge. If your symptoms are due to medication, you may need to drink
more water, take a liquid version of the medication, or try a different medication. You may
need to refrain from lying down for 30 minutes after taking medication in pill form.

What Is the Long-Term Outlook?

Chronic esophagitis can cause narrowing of the esophagus or tissue damage without
treatment. Your chances of developing esophageal cancer are higher if the cells lining your
esophagus have changed.

You can lower your risk of future bouts of esophagitis by avoiding identified triggers.
Your individual outlook depends on the cause and on your overall health. Most people
improve with treatment. Healthy people often recover within three to five days, even without
treatment. Recovery may take longer if you have a weakened immune system.

CONCLUSION
Accourding to my research, esophagitis is often caused by stomach fluid that flows back into
the esophagus. The fluid contains acid which irritates the tissue. This problem is called
gastroesophageal reflux. People who have a weakened immune system may develop
infections that lead to esophagitis. Infection may be due to fungi or yeast (most often
Candida) Viruses, such as herpes or cytomegalovirus. An autoimmune disorder called
eosinophilic esophagitis also causes this condition. And if untreated, this is the possible
complications. Esophagitis may cause severe discomfort. Scarring (stricture) of the
esophagus may develop. This can cause swallowing problems. So you need to stop if you
smoke cigarettes and drinking alcohol if you want to have a long life.

BIBLIOGRAPHY
References: https://en.wikipedia.org/wiki/Esophagitis
http://www.healthline.com/health/esophagitis#Treatment7

Submitted to:

Submitted by:

Kristine Gerpacio Martinez

Annalyn Callueng Tongpalan

Subject Teacher In TLE

Student

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