Dear Doctor,

Recently I developed a hard swelling under my tongue, and it keeps enlarging by the day. At first it was not painful, but recently I started getting a burning feeling. What could this be?

Ibrahim

Dear Ibrahim,

The tongue is a body part made of small groups of several muscles. It is used for talking and swallowing food. Any problem with the tongue can cause much discomfort.

A swollen tongue with throat discomfort can be one of the manifestations of allergy to something eaten or present in atmosphere. Poisoning or allergy to some herbs can also cause this condition. Bacterial infection can cause abscess on the tongue which manifests as a painful swelling. Fungal infection like thrush can also cause a painful tongue. Viral infections like herpes can cause eruptions or swelling, which maybe painful. People with diabetes or HIV infection (reduced immunity) are more prone to these infections. These infections can be detected clinically and are amenable to treatment by medicines.

Chronic inflammation of the tongue can cause redness, swelling and pain or white patches known as leucoplakia. Leukoplakia can turn malignant later on, forming a hard lump. Tobacco chewing is a risk factor for this.

One may get a swelling under the tongue due to blockade of salivary glands in the mouth. This can be due to stones in the salivary glands, chronic inflammation or tumor. The salivation is reduced in these conditions causing dryness of mouth along with the painful swelling. Chronic inflammation can be reduced by antibiotics and anti inflammatory drugs.

Pleomorphic adenoma is a benign tumor which can occur below the tongue. It grows slowly as a hard swelling.

These tumors are diagnosed by biopsy and treated by surgical excision.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital