What is Water Brash & How is it Treated? | Causes, Symptoms of Water Brash

What is Water Brash?

One of the symptoms that many people with GERD experience is overproduction of saliva. This saliva gets mixed with the acids in the stomach that regurgitate to the throat. This is what is termed as Water Brash. Due to this, the person will experience heartburn and an acidic taste in the mouth. Water Brash is also termed as Hypersalivation or Acid Brash.[1]

There is a lot of difference between regurgitation and Water Brash in that in the latter the excessive salivation causes a part of the undigested food mixed with stomach acids to come up through the esophagus. Water Brash does not impact the health of a person but it tends to interfere with activities of daily living and even the professional life of the patient.[1]

What Causes Water Brash?

What Causes Water Brash?

The symptoms of GERD are caused when the body fails to prevent the acids from the stomach from moving back up in the esophagus. In majority of the cases, this happens when the lower esophageal sphincter malfunctions. Another cause which results in Water Brash is malfunction of the phrenico-esophageal ligament which connects the esophagus and the diaphragm. When this ligament does not function normally, it affects the movement of both the esophagus and the diaphragm when swallowing food. It is the weakness of this ligament that causes symptoms of GERD including Water Brash.[1]

Studies suggest that people who have GERD produce excess saliva due to the presence of acids in the stomach that regurgitates back up into the esophagus and activates the esophagus salivary reflex. For this, researchers conducted a test on 15 participants in which they administered saline solution in some and acid solution in others. There was clear increase in the production of saliva in people who were given acid solution. Saliva has very less acidity and thus excess saliva in Water Brash causes a reduction of the overall acidic content in the stomach.[1]

What are the Symptoms of Water Brash?

Heartburn is the primary symptom of Water Brash. This is because the excess saliva mixes with stomach acids. The heartburn will be characterized as burning sensation behind the chest bone. The patients also have an acidic taste in the mouth. Other than this, there are no apparent symptoms associated with Water Brash.[1]

How is Water Brash Treated?

Water Brash can be easily managed with over the counter medications for GERD. In most cases, this is good enough to get rid of the symptoms. However, if the symptoms do not resolve in a couple of weeks then a gastroenterologist needs to be consulted for a thorough evaluation and treatment. Once the symptoms of GERD are controlled Water Brash also resolves.[1]

The aim of the treatment for GERD involves controlling the symptoms and improving the quality of life. At times, GERD also causes inflammation of the esophagus which also needs to be treated. Depending on the severity of the symptoms the physician will recommend antacids or PPIs. There are also some lifestyle changes that need to be made to prevent the symptoms of GERD. These changes include:[1]

  • No eating large meals close to bedtime at night
  • Cutting down on smoking
  • Maintaining an ideal body weight with exercise
  • Staying away from spicy and acidic foods including alcohol close to bedtime[1]

In conclusion, Water Brash is a symptom that an individual with GERD experiences. This involves overproduction of saliva due to the acids in the stomach that come back up the esophagus into the throat. Water Brash is also known by the name of hypersalivation. In most cases, once the symptoms of GERD are relieved Water Brash is relieved as well.[1]

To manage Water Brash, it is important to control the symptoms of GERD. Generally, over the counter medications work effectively but if that is not the case then a consultation with a gastroenterologist is recommended for further evaluation and treatment and relieve Water Brash.[1]

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