Swelling is the body's natural defense mechanism. It helps in fighting bacteria and parasites and helps in healing injuries by enhancing the blood flow to that area. However, prolonged or too much swelling can also be harmful. There are multiple chemical triggers that result in swelling and its subsiding.
Dr. Anna Feldweg of the Harvard Medical School, who specializes in Allergy and Immunology at Brigham Women's Hospital, says that these chemical pathways that trigger swelling are very complicated and are yet to be fully understood by modern medicine. A swollen tongue in particular happens due to a medical problem or an adverse reaction to a medication or an allergy trigger.
Some Common Causes of Swollen Tongue
There are several causes which could result in a swollen tongue, such as:
- Medication: Most cases of a swollen tongue are due to adverse reaction to medications like ACE Inhibitors (angiotensin-converting enzyme inhibitors) used in the treatment of high blood pressure or to NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, etc. A swollen tongue due to an adverse reaction can happen at any time, even if the patient has been taking the medication in question for years.
- Allergens: Apart from allergic reaction to medications, a swollen tongue can also be caused due to allergic reaction to certain other things (foods such as peanuts and tree nuts or bee stings, etc.).
- Streptococcus Infection: This can also cause swollen tongues in some rare cases, and it necessitates treatment with antibiotics. An untreated strep throat can result in dire complications like scarlet fever, rheumatic fever, and/or even kidney failure.
- Acromegaly: This is a rare hormonal disorder, which causes excess growth hormone production in the pituitary gland. A benign tumor called pituitary tumor results in over production of the growth hormones, resulting in oversized organs and bone deformities. If acromegaly is not diagnosed and treated in its early stages, it can severely damage vital organs like the kidneys, liver, spleen, pancreas, etc.
- Amyloidosis: This is a metabolic disorder where accumulation of the amyloidal protein in the organs and tissues causes damage. In extreme cases, they can be fatal. There are many types of this disorder, like primary amyloidosis, secondary amyloidosis, hemo-dialysis related amyloidosis, and familial amyloidosis.
- Angioedema: This term means rapid swelling of the mucosal and sub mucosal tissues. This usually results from allergic reaction to medication, especially in people with high blood pressure. If the swelling is not attended to immediately there is serious risk of asphyxiation.
- Hypoactive Glands: A hypoactive thyroid gland resulting in the deficiency of the thyroid hormone leads to hypothyroidism, causing the body's metabolism and other chemical processes to slow down.
- Down Syndrome: This is a genetic disorder of the chromosomes, wherein a third copy of the chromosome 21 is erroneously created by an abnormality in the mother's egg, resulting in mental and physical disabilities.
Other less common causes of swollen tongue are swollen lymph nodes, tonsillitis in young children, and epiglottitis, a rare condition affecting infants and toddlers. In some rare cases, throat and tongue swelling can also be caused by pernicious anemia, which is the body's inability to absorb the vitamin B12, resulting in depletion of red blood cells.
There is another disease that can cause swollen tongue, called the Kawasaki disease or strawberry tongue, which is quite prevalent. It is a rare autoimmune disorder that can include an underlying cardiac disease, so this condition needs urgent medical attention. However, this is an extremely rare disease that affects very young children. The cause of this disease is yet to be identified to the satisfaction of the medical fraternity. However, if your child has a swollen tongue, consult your pediatrician immediately as the swelling could be due to epiglottitis too.
Treatment for Swollen Tongue
Whatever the cause, a swollen tongue or throat is a serious condition which can rapidly escalate into a life-threatening situation, requiring emergency medical care. Therefore, a swollen tongue must be attended to immediately and treated with the utmost seriousness. Dr. Anna Feldweg recommends that a swollen tongue be treated as an emergency with epinephrine. Once the patient reaches the hospital, antibiotics or steroids can be administered as the need arises, but in an emergency, epinephrine is the drug of choice to treat the swollen throat without placing the patient's life in jeopardy.
Learning about the many causes can help you easily identify the condition behind the swollen tongue, and treat the cause appropriately.
