A swollen tongue can be a type of angioedema , a build-up of fluid in the lower layer of the skin or mucous membranes that can occur in different parts of the body. Medically, a swelling or enlargement of the tongue is called macroglossia and is usually accompanied by redness and other symptoms, depending on the cause.
Allergies, infections, congenital disorders, comorbidities, and certain medications can cause the tongue to swell. Although the condition is generally not an emergency, it can be severe enough to make breathing difficult, and rapidly worsening macroglossia can be a sign of anaphylaxis that requires urgent medical attention.
If you or someone you know has a severe swelling of the tongue, go to the nearest emergency room or call 911.
Symptoms of a swollen tongue
Depending on the cause of the swelling, one or both sides of the tongue may increase in size. In minor cases, the swelling can interfere with food or speech, and if the taste buds are affected, it can cause an unusual taste in the mouth.
- Progressively worsening swelling can block your airways, so it is important to seek medical attention if you ever feel like your tongue is thicker or larger than normal. In some cases, it may be necessary to insert a breathing tube right away.
- Rapid and severe swelling can be a sign of anaphylaxis, which may be accompanied by swelling of the face or lips, hives, shortness of breath, cyanosis (blue lips), nausea, and vomiting.
Tongue swelling can be caused by many different conditions and situations.
The main causes of tongue swelling are food or chemical allergies. You may only have a mild allergic reaction. However, if the tumor is due to anaphylactic shock, it can be fatal.
Symptoms of an allergic reaction usually begin within minutes to hours of exposure to an allergen such as peanuts, tree nuts, milk, eggs, sesame seeds, fish, and shellfish.
Increasingly, dentists are accepting patients who experience reactions to fragrances, dyes, and chemical additives in toothpastes, mouthwashes, denture cleaners, and other oral care products.
After food allergy, drug reactions are the most common cause of angioedema of the face, lips, or tongue in the ED. Such cases are not always associated with allergies.
The reaction may be the result of the body releasing too much bradykinins, which are immune system chemicals normally needed to open blood vessels. They cause swelling if there are too many. Several prescription and over-the-counter medications can cause this type of non-allergic tongue swelling.
A swollen tongue is a rare side effect of medications, but it can be risky with some medications. Angiotensin converting enzyme (ACE) inhibitors , often prescribed to lower blood pressure, often cause angioedema of the tongue.
Between 20% and 40% of emergency department visits associated with drug-induced angioedema are the result of a reaction to ACE inhibitors.
In rare cases, other medications, including antidepressants, pain relievers such as NSAIDs, or medications used to treat high cholesterol levels, can cause a swollen tongue.
Skin conditions can also irritate the tongue, which can cause slight swelling. For example, these diseases cause lesions of the oral cavity and erosion of the oral cavity, as a result of which the tissues around the tongue swell:
- Pemphigus : A group of life-threatening autoimmune diseases that cause mouth sores and skin blisters.
- Lichen planus – A little-explored condition that causes a rash on the skin or mouth.
- Oral psoriasis : leads to the geographic location of the tongue and cracks in the tongue, causing a feeling of swelling or discomfort .
Eating hot food or drinks, biting your tongue, or piercing your tongue can cause temporary swelling that should go away in about five days. If not, consult your doctor.
Severe trauma or piercings in the mouth can lead to a bacterial infection known as Ludwig's angina, with swelling of the area under the tongue. In this condition, your airways can become completely blocked if you don't get treatment.
The mouth is susceptible to a variety of infections, including sexually transmitted ones , which can be transmitted during oral sex. Syphilis, gonorrhea, and the human papillomavirus (HPV) can cause inflammation, sores, warts, or swelling of the tongue and surrounding tissues.
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) can cause chronic irritation of the back of the throat. In some cases, this leads to an increase in the tongue at its base .
Sjogren's syndrome, an autoimmune condition associated with dry eyes and mouth, can cause a variety of oral problems, including enlargement of the salivary and parotid glands ( large salivary glands located on the sides of the cheeks). Among these symptoms, the tongue may be swollen or feel swollen.
Melkersson-Rosenthal syndrome is a rare neurological disorder that mainly affects the facial muscles. Edema can occur, including swelling of the tongue, although facial nerve palsy is more common .
To determine the cause of your tongue swelling, your doctor will examine your tongue and the tissues around it, paying particular attention to a clear airway.
They will also consider the following:
- Is there an immediate danger to your breathing?
- Do you have an underlying medical condition, such as an autoimmune disease?
- Do you have other symptoms, such as hives?
- What is your medical history, medications, diet, and lifestyle?
If your healthcare provider suspects an allergy, drug reaction, or underlying health problem, additional tests may be needed.
If your tongue is slightly swollen, you can seek treatment from your healthcare professional. If the swelling is rapidly getting worse or is accompanied by signs of anaphylaxis, you should go to the emergency room immediately. Initially, treatment will focus on reducing swelling to relieve breathing problems or discomfort, and your healthcare provider will also work with you to prevent future incidents.
Up to 15% of people with angioedema quickly experience a blockage of the airways. This is usually a sign of anaphylaxis and requires a life-saving injection of epinephrine. For less severe allergic reactions, oral antihistamines may be prescribed instead.
If the swelling of the tongue is not related to an allergy, your healthcare provider may use one of the following treatments:
- If you have a reaction that involves too much bradykinin, you may be given medicine to stop its production, which can be given by mouth or by injection.
- For mouth sores and inflammations, you may be prescribed topical corticosteroids or retinoic acid to ease the damage.
If your tongue is swollen due to an infection or a pre-existing condition, your doctor will also prescribe treatment to treat your underlying condition.
Recently, many products have appeared on the market to help relieve dry mouth. You can ask your healthcare provider about prescription oral medications that increase saliva production. There are also over-the-counter mouthwashes and sprays that act like artificial saliva and hydrate the mouth.
If your tongue is slightly swollen and not getting worse, there are some simple things you can do at home to reduce the swelling:
- Eat and drink something cool or suck on ice cubes to calm your mouth and possibly reduce swelling.
- Practice good oral hygiene, such as brushing and flossing, but avoid irritating mouthwashes such as those that contain alcohol.
- Rinse with warm sea water.
- Avoid very acidic or very salty foods.
If a dry mouth makes your tongue uncomfortable, chew sugar-free gum or suck on sugar-free lozenges. Drink much liquid.
Get the word of drug information
Your tongue plays an important role when you eat, speak, and breathe, so any increase can significantly affect your health and quality of life. Even if it looks minor, a swelling could be a sign of infection, tongue cancer, or another health condition that could cause long-term problems.
If you or someone close to you suddenly feel like your tongue is swollen, seek medical attention immediately. And if the swelling is small or gradual, talk with your doctor to find out what you can do to manage your condition.