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ial.gov with National Clinical Trial Number NCT02882971. First bite syndrome (FBS) is a condition in which the first bite of each meal causes parotid pain. Etiologies of FBS include prior surgery of the upper cervical region and, rarely, head and neck tumors. Idiopathic FBS rarely presents in patients without a history of surgery or evidence of an underlying tumor. Idiopathic FBS may be categorized into two subtypes that in patients with diabetes and that in patients without diabetes. Idiopathic FBS in patients without diabetes may be