Author Topic: 'Corticosteroid Irrigation' for dry mouth - anyone tried ?  (Read 3211 times)

kindandcaring

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'Corticosteroid Irrigation' for dry mouth - anyone tried ?
« on: December 18, 2009, 06:09:47 PM »
Anyone tried the gargle methods below.....corticosteroids or and Cevimeline ?

Ive heard of 'Pilorcarpine' gargle but not these two before ?!


Corticosteroid irrigation of parotid gland for treatment of xerostomia in patients with Sj?gren's syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/9797551?dopt=Abstract

Quote
The extent of improvement in salivary function was reciprocal to the clinical severity of the disease, with patients at the early stages obtaining 1.20 (0.57) g net increase in salivary flow rate, and patients at the most advanced stages obtaining 0.20 (0.47) g net increase. Repeated corticosteroid irrigations did not evoke corticosteroid refractoriness of the salivary gland; similar levels of net increase in salivary flow rate were observed after the second to fourth challenge of the corticosteroid in these patients. The sustained period was 8.4 (3.5) months (mean (SD)). CONCLUSION: These findings suggest the clinical usefulness of corticosteroid irrigation therapy in relieving xerostomia in patients with Sj?gren's syndrome.

Another Gargle Treatment:

Parotid Irrigation and Cevimeline Gargle for Treatment of Xerostomia in Sj?gren's Syndrome


http://www.jrheum.com/subscribers/08/11/2289-b.html

Quote
Adverse effects associated with oral doses of cevimeline occurred more frequently in the patients with SS than in those without, suggesting increased sensitivity to the drug in the patients with SS. Adverse effects also occurred with the cevimeline gargle; however, the incidence was much lower than with oral doses of cevimeline. In contrast, irrigation treatment with corticosteroid or saline was not associated with any adverse effects.

Our study confirmed earlier results regarding the usefulness of corticosteroid irrigation for patients with SS5 and further showed that (1) irrigation therapy with the saline solution significantly relieved xerostomia in patients without SS; (2) cevimeline gargle treatment could be an effective adjunct to irrigation therapy for xerostomia in patients with and without SS; and (3) oral doses of cevimeline improved salivary flow rates of xerostomia patients with or without SS. The major beneficial effects were observed in SS patients with severe disease and oral-dose cevimeline. We found no evidence in the blood for cevimeline absorption through the mucosa after the gargle. Instead, the cevimeline might directly activate the minor salivary gland acini.





DragonflyC

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Re: 'Corticosteroid Irrigation' for dry mouth - anyone tried ?
« Reply #1 on: December 19, 2009, 02:51:43 PM »
Interesting! 

I developed a small parotid stone this week, and my rheum put me on a medrol pack (corticosteroids).  Two days later, the swelling is down, and I can't find the stone when I feel around for it anymore.  After that experience, it makes sense that a more direct dose via irrigation would work even better.  I wonder how such a treatment works. 

kindandcaring

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Re: 'Corticosteroid Irrigation' for dry mouth - anyone tried ?
« Reply #2 on: December 19, 2009, 04:11:26 PM »
How do they work..well I think its simply a case of being applied direct to the affected organ..a bit like putting cream on your skin...and we are lucky we can do this...its no different than using Restasis for your eyes..its OK to use Restasis topically but its not so good if you swallow it.


What I find interesting and promising is that the gargle methods appear to act directly on the salivary glands with no evidence of absorbtion into the blood.

 "We found no evidence in the blood for cevimeline absorption through the mucosa after the gargle. Instead, the cevimeline might directly activate the minor salivary gland acini"

And with the corticosteroid gargle the suggested good news is that you can keep using it without the worry of it losing its efficacy as stated here


"Repeated corticosteroid irrigations did not evoke corticosteroid refractoriness of the salivary gland"


Im surprised no one is using a gargle method..even Pilocarpine ?

kindandcaring

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Re: 'Corticosteroid Irrigation' for dry mouth - anyone tried ?
« Reply #3 on: December 20, 2009, 11:27:56 PM »
A pretty quiet response to these gargle ideas for mouth dryness.

For me they "sound" interesting just for the fact one is not having to ingest the drug...saving the body from drug side effects  etc.

I will be pushing my Doc's to look into it..and would be happy to trial one or more of these methods.


ccfbarb

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Re: 'Corticosteroid Irrigation' for dry mouth - anyone tried ?
« Reply #4 on: December 21, 2009, 01:51:29 PM »
I have never tried applied stereoids irrigation for dry mouth, but I have salivary glands under attack from a recent flare, causing dry mouth and a bad taste in my throat that is awful.  I am having other problems signifying this is a flare.  I'm on 40 mg of prednisone for about 4 days now and see a major improvement in the taste issue.  I'm sure the steroids are stopping the attack on my salivary glands by my body's immune system.  It just makes sense.   Interesting treatment in lieu of full out oral steroids, except for me, I have severe leg weakness.

Barb