A client of mine has had difficulties in swallowing food, especially things like canned tuna. Things like canned tuna all their life and feels the need to drink water with every meal. The patient also deals with slight acid reflux every once in awhile by drinking a glass of water. Is there such a thing as lifelong insufficient saliva production? How would you go about treating it?

Dr. Amy Nett: Insufficient saliva production, I don’t know, I’m not sure about that. But I would think about something like Sjogren’s syndrome. So maybe do a little more evaluation and think about some of the more conventional diagnoses. Think about Sjogren’s, think about, you mentioned the acid reflux. I don’t know if you would need to consider CREST in there as well. How old is the patient? Is it male, female? Known autoimmune conditions? Skin issues? All things to think about because if you’re saying insufficient saliva production, I’m wondering about dry mouth issues. If it’s more of a swallowing issue rather than insufficient saliva, you might need to consider a swallowing study to see if it’s a mechanical issue in terms of what’s going on with swallowing. So you might want to look into that a little bit more and maybe some more history there would be helpful, particularly demographics of the patient, that sort of thing. Okay.