Swelling of glands during eating often indicates an issue with the salivary glands. This is a common occurrence, typically resulting from a temporary blockage or inflammation that affects normal saliva flow. Understanding these glands and the factors impacting them helps clarify why swelling occurs.
Understanding Salivary Glands
There are three main pairs of salivary glands: the parotid, submandibular, and sublingual. The parotid glands, the largest, are in front of each ear. Submandibular glands are beneath the jaw, and sublingual glands are under the tongue. These glands produce saliva, essential for digestion, lubricating the mouth, and protecting teeth.
Saliva contains enzymes that begin carbohydrate breakdown and moistens food for easier chewing and swallowing. Salivary glands release saliva into the mouth through ducts. Adults produce 0.5 to 1.5 liters of saliva daily, crucial for oral health and initial digestion.
Common Reasons for Swelling
A frequent cause of salivary gland swelling during eating is salivary gland stones, or sialolithiasis. These calcified masses form within a gland or its ducts, most often in the submandibular gland. When saliva production increases during a meal, a stone can obstruct the duct, causing saliva to back up and the gland to swell painfully. This swelling often appears suddenly or increases before mealtimes, then gradually subsides.
Another common reason is a bacterial infection of the salivary gland, called sialadenitis. This occurs when reduced or blocked saliva flow allows bacteria to multiply within the gland. Symptoms include enlargement, tenderness, and discoloration of the affected gland, sometimes with fever. Unlike stone-related swelling, an infected gland may not fluctuate significantly with eating.
Less Common or Serious Causes
Less frequently, salivary gland swelling can indicate autoimmune conditions. Sjögren’s syndrome is an autoimmune disease where the immune system attacks moisture-producing glands, including salivary glands. This leads to chronic inflammation and enlargement, often affecting both sides of the face, along with dry mouth and eyes. Swelling from Sjögren’s syndrome is typically persistent, not fluctuating with meals.
Viral infections can also cause salivary gland swelling. Mumps, less common due to widespread vaccination, is a classic example causing painful swelling of the parotid glands. Other viruses, including HIV, Epstein-Barr, and influenza, can also inflame the parotid gland. Swelling from viral infections is usually acute and may present with systemic symptoms like fever and malaise.
In rare instances, salivary gland swelling may be due to benign or malignant tumors. Most salivary gland tumors are non-cancerous, causing a firm, usually painless lump or swelling in one gland. Malignant tumors may grow more rapidly and can be associated with facial numbness, weakness on one side of the face, or difficulty swallowing. Any new or growing lump warrants medical evaluation.
When to Consult a Doctor
Consult a doctor if salivary gland swelling persists or is accompanied by other concerning symptoms. Seek medical advice if swelling does not resolve within a week, continues to enlarge, feels hard, does not move when pressed, or is accompanied by severe pain.
Immediate medical attention is necessary for symptoms like high fever, chills, difficulty swallowing, or trouble breathing. Rapid lump growth or signs of facial muscle weakness, such as drooping on one side of the face, also require prompt consultation. These signs may indicate a serious condition needing timely diagnosis and management.
Diagnostic and Management Approaches
When evaluating salivary gland swelling, a healthcare provider begins with a physical examination and symptom review. Imaging tests are often used for further investigation. Ultrasound is frequently the first choice due to its accessibility and ability to detect stones or blockages.
CT scans or MRI may provide a more detailed view, especially if a tumor or abscess is suspected. Blood tests might check for infection or autoimmune markers. If a tumor is suspected, a biopsy (taking a small tissue sample) may be performed to determine if it is benign or malignant.
Management varies by cause; for salivary gland stones, conservative measures like increased hydration, gentle gland massage, and warm compresses can help. Sucking on sour candies or lemon may stimulate saliva flow and encourage stone passage. If an infection is present, antibiotics are often prescribed. For persistent stones or recurrent infections, procedures like sialendoscopy (using a tiny camera to visualize and remove stones) may be considered. Autoimmune conditions or tumors require specialized medical or surgical interventions based on diagnosis.