Can anyone tell me where the excess phlegm comes from with Bulbar ALS.
Bill.

Hi Bill,
The excessive saliva is due to the impairment of swallowing. Most people ( including completely healthy people ) produce about a quart and one half of saliva a day.
In ALS once bulbar impairment occurs, it is not that more saliva is produced. The drooling and excess appearance of secretions is caused by the inabilty to manage it when swallowing is impaired.
If you are talking about phlegm that is yellow or green or has any foul odor. An infection that needs prompt medical attention may be present. And you should be seen by a doctor.
If the phlegm is clear and is just thick secretions some medications may be useful in managing as well, these too can be discussed with a physician though this problem is typically not as urgent medically.
My husband uses scopalimine patches it reduces the saliva problem but does not completely eliminate it.
Lisa

my dad has bulbar als and his doctor gave him a medication that comes in liquid form and in pill form and it has reduced his saliva and coughing-it is working really well-i will get the name of it

lisa you are right -i have heard that the patches work pretty well-this medicine my dad is taking has really helped with the saliva and coughing-i will get the name of it-you may be interested in discussing this with your doctor

I would be very interested int eh name of the meds my phlegm will keep me awake coughing

My husband takes robatussin for the secretions.We are also trying an over the counter allergy medicine.