Vadodara: A 26-year-old NRI from Australia was shocked when the mere thought of his favourite pizza triggered a sharp swelling along his jawline. Over time, his condition worsened to the extent that he began skipping meals out of sheer fear of eating. For him, hunger was not the problem — the very thought of food was.Strange as it may sound, the young man, who has roots in Anand, was suffering from what doctors call “meal-time syndrome”, a disorder characterised by salivary stones that can range from 2 mm to 6 cm in size. The thought, sight or smell of food unleashes a surge of saliva, and when the duct is blocked, the trapped fluid causes intense pain and swelling lasting 30 minutes to an hour.Salivary stones form due to reduced salivary flow, dehydration, infections or changes in saliva composition, leading to calcification inside the ducts. In a surprising development, Vadodara-based GMERS Medical College and Hospital, Gotri, has been drawing hundreds of patients from India and abroad seeking relief from the condition.Three years after undergoing sialendoscopy at the hospital, the NRI now freely enjoys his favourite food. The govt hospital has quietly emerged as India’s highest-volume public-sector centre for sialendoscopy — a minimally invasive, gland-preserving procedure used to treat salivary stones, ductal stenosis and complex salivary gland disorders.Until a decade ago, patients with recurrent obstruction often required surgical removal of the affected gland — particularly the submandibular gland — through an external incision.“Sialendoscopy has completely changed the approach. Earlier, gland removal was common. Now, preservation is the goal,” said Dr Hiren Soni, professor at GMERS Gotri, who introduced the service in 2015-16.Using an ultra-thin 0.77mm endoscope, doctors enter the salivary duct to remove stones, dilate strictures and restore natural salivary flow — all without external incisions. The hospital procured two such scopes in 2015, both of which remain functional. In the last four years, close to 300 patients have undergone the procedure, with two to three cases performed every week — making it the highest-volume govt centre in the country where the treatment is provided free of cost.Referrals now come not only from across Gujarat — including Ahmedabad, Surat, Bhuj, Mehsana and Modasa — but also from Maharashtra, Madhya Pradesh, Rajasthan and Karnataka. International patients from Australia, New Zealand, the UK, the US and Ghana have also travelled to Vadodara for the procedure.“In many cultures, people pray before a meal. That itself stimulates salivary flow. But for patients with blocked ducts, pain begins at that very moment,” Dr Soni said.Apart from meal-time syndrome, the hospital has handled several complex salivary gland disorders affecting chewing, swallowing and speech.One such case involved a 68-year-old retired bank manager suffering from xerostomia — chronic dry mouth caused by reduced saliva production. He struggled to chew, speak and sleep, waking repeatedly at night due to extreme dryness. After undergoing sialendoscopy and receiving medication, his salivary flow improved significantly and his sleep normalised.In another case, a 14-year-old boy with recurring painful swelling near both ears — almost every month — underwent the procedure. In the four years since, he has had only two minor episodes, and none in the past year.Doctors also treated six to seven women with recurrent parotid abscesses who were later diagnosed with Sjogren’s syndrome, an autoimmune disorder affecting the salivary glands. Combined sialendoscopy and medical therapy helped stabilise their condition. What was once a painful, recurring disorder often leading to gland removal is now being treated through a needle-thin endoscope — restoring not just salivary flow, but also the simple joy of eating without fear.
