Persistent Tongue Pain and Inflammation: Possible Causes and Next Steps

Q: Persistent Tongue Pain and Inflammation: Possible Causes and Next Steps

Hello： Upon initial examination, it appears that the primary issue is still inflammation of the tongue, which is commonly due to viral infections. <br>Most cases improve gradually with medication and lifestyle adjustments. <br>If you have already been examined by a physician, it

There is a persistent pain at the back of the tongue?

Hello Doctor: About a month ago, I engaged in kissing and sexual intercourse (without oral sex) with someone of the opposite sex.
Since then, I have been experiencing an unusual odor in my mouth and discomfort in my throat.
I consulted an infectious disease specialist who noted that my tongue coating was somewhat thicker but did not indicate any issues.
Subsequently, I developed a burning sensation on my tongue and pain on the side of my tongue.
I then visited an ENT specialist and underwent an endoscopic examination of my throat.
After the examination, the doctor diagnosed me with tongue inflammation and noted a protrusion on one side of my throat, while the oral mucosa test results were normal.
Last week, I had blood drawn which confirmed elevated allergy levels, so I need to undergo specific allergen testing (waiting for the report next week).
1.
I am confused as to why the doctor would order specific allergen testing when I have tongue inflammation and pain (the protrusion and pain are on the same side)?
2.
My discomfort in the tongue has persisted for almost a month, and the area circled in red in the attached image seems to be expanding, which worries me.
Additionally, I noticed several small red sores in that area of my tongue that are painful.
For the past two days, I have occasionally felt a tingling sensation in my upper and lower lips on the side of my tongue that is uncomfortable.
Could the issues with my tongue be caused by a bacterial or viral infection? Should I undergo further testing for bacteria or viruses? (I have attached two images) http://imgur.com/a/wwpRb Thank you for your guidance!

Kunhuo de ren, 30~39 year old female. Ask Date: 2016/06/12

Dr. Zheng Jueyi reply Otolaryngology

Hello: Upon initial examination, it appears that the primary issue is still inflammation of the tongue, which is commonly due to viral infections.
Most cases improve gradually with medication and lifestyle adjustments.
If you have already been examined by a physician, it is advisable to return for a follow-up to see if the report is related to allergies for continued monitoring.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/06/12

More Info

Persistent tongue pain and inflammation can be concerning, especially when accompanied by other symptoms such as a bad taste in the mouth and throat discomfort. Based on your description, it seems you have already consulted with healthcare professionals, including an infectious disease specialist and an ENT doctor, which is a good first step.
1. Why the Allergy Testing?
The recommendation for allergy testing, despite your symptoms of tongue inflammation and pain, may stem from the fact that allergic reactions can manifest in various ways, including oral symptoms. Allergies can lead to inflammation of the mucous membranes in the mouth and throat, which might explain the discomfort you are experiencing. The presence of a thickened tongue coating could also be a sign of an allergic response or irritation. By identifying specific allergens, your doctor can help tailor a treatment plan that addresses the underlying cause of your symptoms.

2. Duration and Symptoms of Tongue Discomfort
You mentioned that your discomfort has persisted for nearly a month, with the affected area on your tongue appearing to expand and develop small red sores. This could indicate a few potential issues:
- Infection: Both viral and bacterial infections can cause inflammation and pain in the tongue. For instance, conditions like oral thrush (a fungal infection) or herpes simplex virus can lead to similar symptoms.
- Geographic Tongue: This benign condition can cause patches on the tongue that may appear red and inflamed, often with a burning sensation.
- Allergic Reactions: As previously mentioned, allergies can lead to inflammation and discomfort in the oral cavity.

- Oral Lichen Planus: This is an inflammatory condition that can cause painful lesions in the mouth, including the tongue.

3. Next Steps and Recommendations
Given that your symptoms have persisted and evolved, it would be prudent to follow up with your healthcare provider. Here are some steps you might consider:
- Further Testing: If your symptoms do not improve or worsen, additional tests may be warranted. This could include cultures to check for bacterial or viral infections, or even a biopsy if lesions persist.

- Symptomatic Relief: In the meantime, consider using topical anesthetics or mouth rinses that can help soothe the pain. Avoiding spicy, acidic, or irritating foods may also provide relief.

- Monitor Symptoms: Keep a detailed record of your symptoms, including any changes in the appearance of your tongue or the presence of new symptoms. This information can be invaluable for your healthcare provider.

4. When to Seek Immediate Care
If you experience severe pain, difficulty swallowing, or if the lesions on your tongue begin to bleed, seek immediate medical attention. These could be signs of a more serious condition that requires prompt intervention.

In conclusion, while your symptoms may be related to an allergic reaction or infection, it is essential to continue working closely with your healthcare providers to determine the exact cause and appropriate treatment. Your health and comfort are paramount, so do not hesitate to seek further evaluation if your symptoms persist or worsen.

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