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Cure for sub-mandibular gland swelling - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   hello?
Doctor :   hi
Doctor :   please proceed with your health query
User :   I have a swollen submanibular gland
Doctor :   ok.
User :   It's been this way for five weeks
User :   I've been to three doctors and yesterday went to an ENT
Doctor :   ok. what did the ENT specialist suggest?
User :   It appears I have an embedded obstruction in the gland
User :   I am having it reomved nest Tuesday
Doctor :   ok
User :   The only symptom is a very large lump
Doctor :   what is the cause suggested for the obstruction?
User :   I have no night sweats, fever, loss of weight, etc
Doctor :   ok
User :   When I woke up a few minutes ago the lump is extremely large
Doctor :   what tests were conducted for evaluation of the submandibular swelling?
User :   The nurse had suggested I put warm compresses on it and assage it
User :   I think this aggrevated it
User :   she said it wouldn't
Doctor :   could you describe the approximate size and appearance of the lump before and after you woke up?
User :   Initially there was no pain with the it is getting somewhat tender
Doctor :   the increase in size will tend to have stretch effect causing the pain
Doctor :   do not massage it, or press on it.
Doctor :   use cold compresses, it will help in inflammation getting down
Doctor :   and help with pain also
Doctor :   could you describe the approximate size and appearance of the lump before and after you woke up?
User :   it looked like a half of a tennis ball under my chin
Doctor :   is there any change in color or texture of skin over it?
User :   Now its like a full tennis ball
Doctor :   ok
User :   Not that I can tell
Doctor :   ok
Doctor :   are you on any medications?
User :   Initially, my second doctor said he could see what seemed to be a blockage on a xray
Doctor :   ok
User :   I was on ZPAC two times
Doctor :   ok
User :   The first time it seemed to help
User :   the second time I didn't notice a difference
Doctor :   ok
User :   Ibprophrean
Doctor :   what is the consistency of the swelling?
User :   very hard
Doctor :   is it firm/hard/soft?
Doctor :   ok
User :   it almost feels like bone
Doctor :   then i would suggest you to do cold comprssed, not with pressure over it, but gentle ones
Doctor :   and go to ER and get it evaluated again
User :   tonight?
Doctor :   if there has been a bleed inside, it could have increased in size fast. and should be controlled
Doctor :   or you can call up your treating doctor and inform about the increase in size and the consistency of swelling
User :   I had an exam yesterday
User :   I don't have the fluxation in size that I read a lot about
Doctor :   continue with cold compresses, if it does not help with the pain and the increase in size, then do not wait, go for an evaluation
User :   before or during meals
Doctor :   you said earlier that you felt the swelling as increased after you woke up
User :   how long should I use the cold compress
Doctor :   so getting an urgent evaluation done is better
User :   Ok, I'll call him tomorrow
Doctor :   you can use cold compresses for about an hour, use every 10-15 minutes for 10 minutes duration
User :   with ice?
Doctor :   usually such fast increase in size is not considered a good sign.
Doctor :   yes with ice wrapped in a small towel
User :   The ent did do an ultra sound
User :   He saw what he thought was a large stone
User :   He said there was "stranding" which he said was indicative of a stone
User :   I think that was the term he used
Doctor :   ok
Doctor :   when was this ultrasound done?
User :   yesterday
Doctor :   since how long back have you noticed the increase in size of the swelling?
User :   The whole thing started five weeks ago with a small lump
User :   It grew quickly and in two weeks it had become very large
User :   I should mention that I messaged it about three weeks ago and the lump got about the sam size
User :   I went to a doctor who diagnosed a swollwn gland, gave me zpac
Doctor :   ok
User :   It went down quite a bit
Doctor :   does the lump increase in sizeeach time you have massaged it?
Doctor :   *size each
User :   Not every time, but when I am more aggressive and yesterday I massaged it with warm compacs
Doctor :   then the probable cause for increase in size is teh maasage and the hot compress
Doctor :   do not try them again
User :   I won't
Doctor :   start with the cols compresses, be gentle, do not press
Doctor :   or put pressure
User :   I am worried it could be cancer
Doctor :   continue with the medications
User :   I don't have any other symptoms
Doctor :   if cancer is suspected getting an FNAC (fine needle aspiration cytology) or biopsy will help.
Doctor :   but since you are not having any other symptoms, you can relax
User :   Would you expect me to have other symptoms at this point if it were more serious?
Doctor :   yes, you could have had weight loss, anorexia, pain, weakness, fever, change in appearance and color etc
Doctor :   since it is about 5 weeks duration
Doctor :   do you have any of these symptoms?
User :   Like those you mentioned? no
Doctor :   then you can relax, get started with the cold compresses, meet your doctor tommorow to control the increase in swelling
Doctor :   and proceed with the suggested treatment
User :   I have aquestion about the swelling
Doctor :   the stone like appearance on the x-ray could be a possible calcification inside the swelling due to repeated inflammation
Doctor :   ok. please proceed
User :   would total blockage keep the lump from reducing?
User :   I read where most time the lump goes up around meal time then goes down
User :   my stays about the same
Doctor :   if it is the submandibular gland swelling with blockage of the duct, then it can lead to increase in size, inflammation during meal time
Doctor :   partial or incomplete block will not lead to such symptoms
User :   I think the blockage is in the gland
User :   I understand about the size, but why isn't it going down?
Doctor :   blockage in the gland will not have any effects, it the duct that empties the gland, and the blood vessels that supply and drain it, so any blockage in them will lead to symptoms.
User :   also, is the size I discribe (about four inches long by two inches wide) seem unusually large?
User :   Have you heard of bigger?
Doctor :   it is not going down probably because it is inflammed, and active inflammation will not let it go down
Doctor :   it is big what you are describing.
Doctor :   start with cold compresses to control the inflammation and thereby the size
User :   can you clarifiy? A stone in the gland won't cause blockage?
User :   what would cause the inflammation?
Doctor :   a stone or calcification can cause blockage and depending on the size of it and the location, the effects would vary.
Doctor :   yes, it will cause inflammation.
User :   the stone?
Doctor :   yes, as it will cause local irritation, and hence the inflammation
Doctor :   sometimes even infection
User :   I don't think its infected
Doctor :   which when massaged will tend to increase the problem
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