Parotid enlargement is more common in alcoholic cirrhosis and has been attributed to protein deficiency as in malnutrition. The pathology behind salivary gland enlargement is sialadenosis which is usually bilateral, soft, symmetrical and non-tender. The two postulated mechanisms are:
1. Cellular hypertrophy - autonomic nerve dysregulation (due to demyelinating polyneuropathy) leading to accumulation of intracellular zymogen granules either via increased production or reduced secretion from the cell.
2. Fatty infiltration