Definition
A swollen tongue is an increase in size and volume of the tongue, which affects either part or all of its surface. The reason for the increase in size is an increased accumulation of fluid in the tissue of the tongue, which in most cases is caused by inflammation. It is not uncommon for it to be accompanied by a change in the nature of the surface. Reddening, small pustules or a white coating are therefore not rare accompanying symptoms. The sensation of the swollen tongue can range from painful to numbness and often gives an indication of the cause.
Causes
The causes of a swollen tongue can be of various kinds. The most common is burning the tongue with food that is too hot or with objects such as cutlery. It leads to local swelling of the tongue where the foreign body has touched the tongue.
A sharply defined swelling is typical here, which is accompanied by an injury to the mucous membrane. Depending on the degree of burning, this can be a reddening, a blistery change or even a bloody wound. In this case, the affected person can also directly identify and assign the cause.
Furthermore, an allergy is often the trigger for the swelling of the tongue. If the mucous membrane of the mouth range and thus also the tongue come into contact with the allergen (e.g. nuts), it can swell massively within few minutes with a strong sensitivity of the concerning. Typical for allergic reactions is the swelling of the entire tongue.
In addition, the mucous membrane of the cheeks and palate is also irritated and becomes painful due to the inflammatory change. Depending on the sensitivity of the person affected to the allergen, the swelling may be subtle or may only appear after some time. The recognition of the allergen as cause can be here in some cases more difficult.
Drugs are less often the reason for a swollen tongue. Especially blood pressure medications lead to a swelling of the mucous membrane of the tongue. However, they also usually lead to fluid retention in the vocal chords, so that an annoying cough can occur at the same time.
In the worst case, the swelling can also lead to shortness of breath. However, pointing out the possible side effects when taking these drugs minimizes this risk, which is one of the rare side effects in terms of numbers. An allergy is a hypersensitivity reaction of the own body to an actually harmless stimulus from the environment.
It manifests itself with the concerning in an excessive activation of the immune system, which shows itself again in inflammatory reactions in the form of swelling, reddening and an increased temperature. A swollen tongue is mainly caused by food allergies. The decisive factor here is the contact of the food with the mucous membrane in the mouth area.
The numerous cells of the immune system contained there falsely recognize the ingredient as foreign and initiate a defense reaction. Depending on how strong the sensitivity of the affected person is, the defense reaction can range from a furry-deaf feeling to a strong swelling of the tongue with shortness of breath. The swelling causes the defense cells to reach their destination to neutralize the allergen.
A characteristic feature of allergic reactions is that the entire tongue swells up quite evenly. In such cases it is necessary to stop the supply of the allergen immediately and to intervene medically. The danger is that the swelling causes the airways to become blocked, resulting in dangerous breathing difficulties.
Antihistamines are suitable as medicines for mild reactions, and medically prescribed cortisone for more severe reactions. Pollen or animal hair allergies do not express themselves rather with a swollen tongue. Here it is above all an itching palate or an increased sneezing that impairs the concerning.
In order to identify the triggering allergen for the swollen tongue exactly, however, a prick test at the doctor is suitable. A swollen tongue with a cold is relatively unusual. A cold in itself is an upper respiratory tract infection.
This means that the mucous membranes of the mouth, nose and throat are usually infected with viral pathogens. It is typical that the nasal mucous membranes and the throat are particularly affected. Of course, the tongue also comes into contact with the pathogens, but it is rarely seriously colonized by so-called “cold viruses“.This is because most pathogens in the nose and throat ring are intercepted by lymphatic tissue.
This lymphatic tissue contains a particularly large number of defence cells and is an important component of the body’s own immune system. If, however, the tongue should swell during a cold, it is probably mainly the base of the tongue. It is located at the root of the tongue towards the throat and lies visually under the uvula.
Here, too, there is more lymphatic tissue to be found. In case of a strong virus infection, this part of the tongue may swell. However, the fact that the entire tongue increases in volume is rather unusual for a cold.
Then perhaps intolerance reactions to medication or an infected wound on the tongue should be considered. If a swollen tongue occurs for a short time to a few days after taking antibiotics, it is an intolerance reaction against the active substance. It is necessary to stop taking the medication immediately and replace it with a new one if necessary.
However, it is very rare that a swollen tongue is the only reaction to an antibiotic. In these cases the general condition is often impaired. Affected persons feel an additional change to their already existing disease that has led to taking the antibiotic.
This can be a skin rash or a renewed rise in fever, for example. In addition, swelling of the mucous membranes in the entire mouth area is often observed. Stress usually does not lead to a clearly swollen tongue.
It is rather the subjective feeling of the person affected. It is caused by the reduced salivation under stress. Reactively, the tongue becomes dry and it can lead to small tears in the mucous membrane of the tongue.
These can in turn become inflamed and lead to swelling of the tongue. However, the swelling is usually minimal and can be easily avoided by a balanced fluid intake. However, since the sensitive innervation of the tongue is so pronounced, the minimal swelling is perceived as being oversized.
However, this can be refuted by the fact that the affected persons can usually move their tongue normally and articulation is not affected by the swelling. A swollen tongue is normal after a tongue piercing. The swelling is caused by the injury to the tongue.
The wound leads to the onset of wound healing and as a result, increased fluid retention. The fluid should help to bring the cells needed for the repair to their destination. The swelling around the piercing should be limited and should decrease with the healing process.
An increasing redness, stronger pain or even purulent deposits should not appear after the piercing. A disturbed function of the thyroid gland can also lead to a swollen tongue. In most cases this is an underfunction of the thyroid gland.
The tongue then becomes dry in the advanced stage and increases in size. However, other symptoms are in the foreground. Especially in the beginning, it is an increasing tiredness and sensitivity to cold that the affected persons notice.
Weight gain is also typical. A chronic liver disease can certainly lead to changes in the tongue. However, the emphasis here is on the fact that it can lead to changes but does not have to.
Furthermore, changes in the tongue are not specific to liver disease. It is therefore important to consider the combination of these symptoms with other symptoms. Experts often speak of so-called “liver skin signs”.
They are characteristic for chronic liver diseases and can be determined purely visually. This also includes the “varnish tongue”. The name already suggests that it is a shiny, deep red tongue.
It is also often painful. A swelling is variable. However, it is never isolated, but can be accompanied by further symptoms like red palms and soles of the feet, a missing hair on the belly (“belly glands”) and liver asterism.
The latter manifest themselves in star-shaped skin bleedings, which can be present all over the body. If you press on their center with a normal pen, the skin discoloration disappears. In addition, those affected also suffer from general disorders such as increasing tiredness, digestive problems or pain in the right upper abdomen.
General symptoms are more likely to lead to a diagnosis than the changes on the tongue.A swollen tongue can also be an indication of a vitamin deficiency. Especially an undersupply of vitamin B3 and vitamin B12 can manifest itself in an inflamed, red tongue that burns painfully. In order to determine the deficiency reliably, a blood sample must always be taken.
If a vitamin deficiency should prove to be true, vitamins can be supplied in increased quantities in the form of capsules or a conscious diet. Almost only animal foods such as fish, meat, eggs and dairy products contain a high vitamin B content. They should therefore be prepared with preference.