Discover the possible causes of tongue swelling, from allergic reactions to infections, and learn how to manage the symptoms.

Swelling of the tongue, medically known as “glossitis,” can be a worrying symptom that may indicate an underlying health problem. The tongue is a crucial organ responsible for various functions such as speech, swallowing and taste. Any anomaly or inflammation of the tongue can significantly affect these functions and be a sign of an underlying disease.

Swelling of the tongue can be due to various causes, from minor irritations to more serious conditions. A common cause is an allergic reaction. When exposed to certain allergens, such as foods, medications, or insect bites, the body’s immune system can react by releasing histamines. This immune response can cause inflammation and swelling of the tongue. Additionally, infections, such as oral thrush or candidiasis, can also cause swelling of the tongue. These fungal infections are usually caused by an excessive growth of natural yeast in the mouth.

Table 1: Common causes of tongue swelling

Injuries to the tongue, such as accidental bites or burns, can also cause swelling. Physical trauma to the tongue can cause discomfort, pain, and inflammation. Additionally, some underlying diseases, such as hypothyroidism or vitamin deficiency, may be associated with tongue swelling. It is important to identify the underlying cause of tongue swelling as it can guide appropriate treatment measures and relieve discomfort.

Allergic Reactions

An allergic reaction occurs when the body’s immune system overreacts to a specific substance, known as an allergen. These allergens can range from common foods and medications to environmental factors such as pollen or pet dander. When an allergen is introduced into the body, the immune system produces immunoglobulin E (IgE) antibodies, which trigger the release of histamine and other chemicals. This release of chemicals causes symptoms often associated with allergic reactions, such as swelling of the tongue.

Causes for Tongue Swelling in Allergic Reactions

Anaphylaxis: Severe allergic reactions can lead to a life-threatening condition called anaphylaxis. During an anaphylactic episode, the body experiences a rapid and widespread release of histamine, which causes swelling not only in the tongue but also in the throat, making it difficult to breathe. Anaphylaxis requires immediate medical attention and the use of epinephrine to reverse symptoms.

Food allergies: Certain foods can trigger an allergic reaction, causing swelling of the tongue. The most common food allergens are peanuts, tree nuts, shellfish, eggs and milk. In some cases, even a small amount of the allergenic food can cause swelling of the tongue and other allergic symptoms.

Examples of common food allergens

Food	Symptoms
Peanuts	Swelling of the tongue, hives, difficulty breathing
Seafood	Tongue swelling, itching, abdominal pain
Milk	Swelling of the tongue, nausea, vomiting

Insect stings: Allergic reactions to insect stings, such as those from bees, wasps, or hornets, can also cause swelling of the tongue. This type of reaction can occur in people who are hypersensitive to insect venom. In severe cases, it can cause anaphylaxis and requires immediate medical attention.

Causes for Tongue Swelling: Infections

Infections can be a common cause of tongue swelling. The tongue, being a humid and warm environment, can constitute an ideal breeding ground for various microorganisms. These infections can range from viral to bacterial, and can cause discomfort and swelling of the tongue.

1. Viral infections: Viral infections such as herpes simplex virus (HSV) and human papillomavirus (HPV) can cause swelling of the tongue. HSV can cause painful blisters on the tongue, while HPV can cause warts to appear on the lingual surface. These viral infections are very contagious and can be transmitted through direct contact with an infected person.

It is important to practice good hygiene and avoid contact with people who have symptoms of viral infections to prevent the spread of these infections and reduce the risk of tongue swelling.

2. Bacterial infections: Bacterial infections can also cause tongue swelling. Streptococcal and staphylococcal bacteria are the most common culprits. These bacteria can penetrate the body through cuts or wounds in the tongue, causing inflammation and swelling. In addition, poor oral hygiene can create an environment conducive to excessive bacteria growth, which increases the probability of tongue infections.

1. Streptococci: streptococcal bacteria can cause conditions such as streptococcal pharyngitis, which can cause inflammation and discomfort in the tongue. Adequate antibiotic treatment is necessary to eliminate infection and relieve symptoms.
2. Staphylococci: staphylococcus bacteria can cause infections such as cellulite, which can affect the tongue. This infection can cause redness, swelling and pain in the affected area. Timely medical intervention is essential to prevent infection from spreading and causing more complications.

Tongue Injuries

1. Cortes and lacerations: One of the most frequent types of lingual lesions, cuts and lacerations can be caused by accidental bites, falls or sharp objects. These lesions usually cause bleeding and visible wounds on the surface of the tongue. In some cases, the cuts can be deep and require medical intervention to stop the bleeding and close the wound. It is important to seek immediate medical attention in case of serious cuts.

1. Accidental bites: accidentally biting the tongue when eating or speaking can cause small cuts and abrasions. These injuries are usually cured by themselves in a few days.
2. Falls: Falls or blows with the chin can cause tongue injuries due to sudden impact. The tongue can be trapped between the teeth and cause cuts or lacerations.
3. Sharp objects: The careless use of sharp objects such as sticks or utensils in the mouth can accidentally injure the tongue, causing cuts and wounds.

Note: In case of severe bleeding, inability to control bleeding or deep cuts, immediate medical care should be requested.

2. Burns and scalds: Exposure of the tongue to extreme heat can cause burns and scalds. Hot foods or drinks are common culprits for tongue burns. Depending on the severity, burns can cause pain, swelling, blisters, and damage to the taste buds. Treatment of tongue burns usually involves controlling pain, preventing infection, and promoting healing.

Oral Cancer: A Potentially Life-Threatening Condition

There are several risk factors associated with the development of oral cancer. The most important risk factor is tobacco use, which includes smoking cigarettes, cigars, and pipes, as well as chewing tobacco. Alcohol consumption, particularly excessive and prolonged consumption, is another important risk factor. Additionally, exposure to certain types of human papillomavirus (HPV), a sexually transmitted infection, has been linked to an increased risk of developing oral cancer.

Important information:

1. Oral cancer can affect anyone, but people over 40 and men are most at risk.
2. Regular dental checkups and oral cancer screening can help detect the disease at an early stage.
3. Early detection is crucial for successful treatment and improved prognosis.

It is important to know the signs and symptoms of oral cancer, as early detection significantly increases the chances of successful treatment. Common symptoms include persistent mouth sores, red or white spots in the mouth, difficulty swallowing or chewing, a lump or thickening in the mouth or throat, and unexplained bleeding or numbness in the mouth. If any of these symptoms occur, it is crucial to seek medical attention immediately.

Inflammatory Conditions: Causes for Tongue Swelling

Inflammatory conditions that affect the language can have various causes, such as infections, injuries, allergies and certain medical conditions. These conditions can cause a localized or generalized swelling of the tongue, hindering food, speech and even breathing. It is important to identify the underlying cause of tongue swelling to provide adequate treatment and avoid subsequent complications.

Important note: tongue swelling can be a sign of a severe allergic reaction called angioedema. In these cases, immediate medical care is crucial, since it can cause difficulty breathing and possible potentially mortal complications.

• Oral infections: infections such as oral candidiasis, fungal infection, or bacterial infections such as glossitis can cause swelling and discomfort in the tongue.
• Trauma: Language injuries, as accidentally biting it or becoming piercing, can cause inflammation and swelling.
• Allergies: allergic reactions to certain foods, medications or environmental factors can cause tongue swelling as part of a generalized allergic response.
• Autoimmune disorders: conditions such as oral plan or vulgar pénfigo, which are autoimmune disorders, can cause inflammation and swelling of the tongue.

1. Side effects of medicines: some medications, such as no n-steroidal ant i-inflammatories (NSAIDs) or angiotensin converting enzyme inhibitors (BC), can cause tongue swelling as a side effect.
2. Oral ulcers: recurrent or chronic mouth ulcers, such as those associated with autoimmune disorders such as Behçet’s disease, can cause tongue swelling.

Angioedema: Understanding the Causes and Symptoms

Angioedema may be due to several causes, such as allergic reactions, certain underlying medications and diseases. Allergic angioedema occurs as a result of an exaggerated immune response to allergens such as insect bites, certain foods or medications. Medicatio n-induced angioedema can be caused by drugs such as angiotensin converting enzyme inhibitors (IECA), usually used to treat arterial hypertension. In addition, angioedema can also be idiopathic, that is, of unknown cause.

Allergic Angioedema:

Allergic angioedema is one of the most common causes of tongue swelling. It usually occurs as a result of a hypersensitivity reaction to certain allergens, such as shellfish, peanuts, or insect bites. When an allergen enters the body, it triggers the release of immunoglobulin E (IgE) antibodies, which cause blood vessels in the affected area to leak and swell. This can cause swelling of the tongue, lips or throat, making it difficult to breathe and potentially causing a life-threatening allergic reaction known as anaphylaxis.

Medication-Induced Angioedema:

Drug-induced angioedema is usually a side effect of certain drugs, mainly ACE inhibitors. These medications block angiotensin-converting enzyme, which helps relax blood vessels and lower blood pressure. However, in some people, ACE inhibitors can cause blood vessels to leak fluid, causing angioedema. In severe cases, swelling of the tongue may occur, which may be a medical emergency if it affects breathing or swallowing.

Angioedema can range from mild to severe and may require immediate medical attention, especially if the swelling of the tongue affects the person’s ability to breathe or swallow. Identifying the underlying cause of angioedema is crucial, as treatment approaches can vary depending on the specific trigger. If you are experiencing symptoms of angioedema, it is important to consult a healthcare professional to determine the cause and determine the appropriate course of action.

Food Sensitivities: A Common Cause of Tongue Swelling

Food sensitivity can be caused by a variety of factors, including genetics, environmental triggers, or even prior exposure to certain foods. Common culprits of tongue swelling in people with food sensitivities include allergenic proteins, food additives, and certain preservatives.

It is important to note that food sensitivities are different from food allergies. Although both conditions involve an immune system response, food allergies typically trigger immediate and severe symptoms, while food sensitivities can manifest over time and present with milder symptoms.

Signs and Symptoms of Food Sensitivities

Recognizing the signs and symptoms of food sensitivity can be crucial to identify the cause of tongue swelling. In addition to tongue swelling, people with food sensitivity may experiment:

• Itching or tingling in the mouth or throat.
• Eruption or urticaria on the skin
• Nausea or vomiting
• Abdominal pain

In some cases, tongue swelling due to food sensitivity can be accompanied by difficulty breathing, swallowing or speaking. It is important to seek immediate medical attention if these serious symptoms occur.

Medication Side Effects

The side effects of medications refer to the adverse reactions that can occur after taking a specific drug. These side effects can manifest in different ways, such as physical symptoms or changes in mood or behavior. They may appear immediately after starting a new medicine or developing over time, as the body adapts to the drug.

Some usual side effects of medication are

• Nausea and vomiting
• Dizziness or drowsiness
• Headaches
• Stomach or diarrhea discomfort

It is essential that you carefully read the drug label and the instructions facilitated by your health professional. This will help you understand the possible side effects and what to do if they occur. If you experience any serious or persistent side effect, it is crucial that you look for immediate medical attention.

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Author of the article

Dr.Greenblatt M.

Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont