The salivary glands produce saliva to lubricate the mouth and throat, begin the process of breaking down food, and make swallowing easier.
People normally swallow saliva unconsciously throughout the day. Sometimes, however, a person can accidentally inhale saliva. Saliva can also accumulate in the throat, making it difficult to breathe.
Certain neurological, muscular, and respiratory conditions, however, can make coughing difficult or affect a person's ability to swallow. In some cases, a person may need to take proactive measures to help clear saliva and other secretions in the throat.
Several overlapping factors can cause a person to choke on saliva. Dysphagia, or difficulty swallowing, is the main reason that most people choke on saliva. Several medical conditions can cause dysphagia.
In this article, we discuss the main causes of choking on saliva and some prevention methods.
Choking on saliva can be alarming.
Many people have had the uncomfortable experience of temporarily choking on saliva. This can feel as though saliva has gone down the wrong pipe.
The windpipe is right next to the esophagus, or the tube down which food travels. Normally, a small flap of cartilage called the epiglottis prevents people from inhaling food, saliva, and water.
However, sometimes, the epiglottis does not fully close the windpipe, which can cause a person to inhale saliva, water, or food.
Healthy people are usually able to cough the saliva back up. People with muscle or neurological conditions, however, may not be able to do so.
People are more likely to choke on saliva when they talk while swallowing. This is because talking requires air, so the epiglottis cannot fully close the windpipe when a person talks.
Some medical conditions cause a person to choke on their saliva. The most common reason that people choke on saliva is that they have difficulty swallowing. This makes it difficult for them to clear the airway by swallowing saliva and other substances that the airway secretes.
Dysphagia makes it difficult for people to swallow. Some find swallowing painful, while others have trouble coordinating the many muscles involved in swallowing. Dysphagia is a symptom, not a diagnosis. Another condition usually causes dysphagia.
Doctors have identified two main types of dysphagia:
- Oropharyngeal dysphagia: This causes swallowing problems that affect the throat and the top of the esophagus. Neurological and muscular issues usually cause this type of dysphagia. For example, damage to the cranial nerves in the brain can affect its ability to communicate swallowing signals to the throat.
- Esophageal dysphagia: This type causes problems lower in the esophagus. Structural problems can damage the esophagus, triggering this type of dysphagia. For example, a person with scar tissue in the back of the throat might not be able to swallow normally. Infections can also weaken the esophagus, making swallowing more difficult. People with this type of dysphagia may feel as though something is stuck in the throat.
Some conditions that might cause dysphagia include:
Sometimes, a doctor may not be able to identify a specific cause of dysphagia. When this happens, they call the condition idiopathic dysphagia.
Lung health issues
Having pneumonia can increase the risk of choking on saliva.
Lung health problems can cause dysphagia, making swallowing more difficult.
Some lung health issues also cause the body to produce more saliva and mucus, while making it more difficult for a person to cough or swallow. When this happens, a person can choke on saliva or mucus.
Cystic fibrosis, for example, is a genetic condition that can cause thick, sticky saliva and mucus to build up in the lungs and throat. A person can choke or have trouble breathing if they are unable to cough up this mucus.
Other conditions, such as chronic obstructive pulmonary disease and pneumonia, may also raise the risk of choking on saliva.
A doctor may recommend breathing exercises and airway clearance strategies for people with lung conditions. In some cases, a person may require a breathing tube.
Conditions that weaken the muscles may increase the risk of choking on saliva by making it harder for a person to cough.
Some muscle conditions can also damage the esophagus, making it harder to push saliva and anything else a person swallows down into the stomach.
Muscular dystrophy, for example, causes progressive weakening of the muscles of the body. When this disorder affects the throat or the esophagus, it can make swallowing more difficult, causing a person to choke on saliva.
The right treatment for muscle disorders depends on the disorder. Some people benefit from physical therapy, while others may need to take medication.
Even when a person's muscles work well and they are physically capable of swallowing, neurological issues can cause them to choke on saliva or anything else they swallow.
Parkinson's disease, for example, damages the brain's ability to send signals to parts of the body that affect mobility. This can cause swallowing issues and choking.
Neurological conditions affecting cognition, such as dementia, may also cause a person to choke on saliva. People with traumatic brain injuries or spinal cord injuries may also not be able to swallow normally.
Many neurological conditions get progressively worse with time. Treatment can be challenging and may change as the condition evolves. Some people with neurological conditions see improvements with swallowing or speech therapy.
Newborns and young infants are more likely to choke, as their airways are still developing. Premature infants are more vulnerable to respiratory infections and disorders. These conditions may increase the risk of choking.
Caregivers should discuss breathing concerns with a doctor and immediately see a pediatrician when any signs of respiratory distress arise. Noisy breathing, nostril flaring, and a collapsing chest when breathing may be signs of a breathing emergency. Call 911 or go to the emergency room.
Risk factors and prevention
Speech therapy may help some people who choke on saliva.
Although anyone can choke on saliva because of the proximity of the windpipe to the esophagus, some medical conditions make choking more likely.
Some strategies that may prevent choking in vulnerable people include:
- regular airway suctioning
- breathing exercises
- swallowing or speech therapy
If a person chokes on saliva, encourage them to cough. If they are unable to cough or seem unable to breathe, call 911. A doctor or paramedic may need to suction the airway to help them breathe again.
Many people worry about the dangers of choking on saliva, because it can be painful and cause feelings of fear.
People with functioning respiratory and neurological systems need not worry about choking on saliva. For those with dysphagia or other risk factors, however, choking presents a legitimate danger.
Such people should work with a doctor to devise a plan to reduce choking risk.