Which Specialist to Consult for Alcohol-Related Facial Swelling?

Q: Which Specialist to Consult for Alcohol-Related Facial Swelling?

Dear Mr. <br>Hsiao：<br>1. <br>Since you have already consulted many specialists and undergone numerous tests, including a CT scan, and no issues have been identified, it is theoretically unlikely that a diagnosis such as a tumor is present; however, it remains challenging to pinp

Which specialty should I see?

Hello, whenever I consume alcohol or alcoholic beverages, such as rice wine in dishes like Shao Jiu Chicken or Shao Jiu Shrimp, my right cheek swells up.
I also feel a painful and tight sensation in a muscle on the right side of my neck, and my right eye experiences increased pressure, leading to swelling.
The right side of my face is affected, with noticeable cheek swelling, and while it doesn't hurt when touched, there feels like a hard lump.
This condition gradually subsides after about an hour.
I've been experiencing this for nearly two years and have consulted various specialists, undergone X-rays and CT scans, but no issues have been identified.
I truly don't know which specialty to consult or how to proceed with treatment.

Xiao Xiansheng, 20~29 year old female. Ask Date: 2019/03/19

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Hsiao:
1.
Since you have already consulted many specialists and undergone numerous tests, including a CT scan, and no issues have been identified, it is theoretically unlikely that a diagnosis such as a tumor is present; however, it remains challenging to pinpoint the exact cause.
2.
Clinically, many diseases are difficult to diagnose; particularly in our country, hospitals are overwhelmed with patients, making it hard for physicians to conduct thorough inquiries, physical examinations, and thoughtful assessments.
I personally recommend that you gather and organize the reports of the tests you have undergone, and then discuss them with your primary care physician, or directly consult a neurologist at a hospital.

Reply Date: 2019/03/19

More Info

If you are experiencing facial swelling and discomfort specifically related to alcohol consumption, it is crucial to consult with the right medical specialist to address your symptoms effectively. Given the nature of your symptoms—swelling of the right cheek, tightness and pain in the neck, increased eye pressure, and transient hard lumps that resolve after about an hour—there are several potential avenues for diagnosis and treatment.

1. Otolaryngologist (ENT Specialist): Since your symptoms involve facial swelling and discomfort in the neck area, an ENT specialist would be a good starting point. They can evaluate for any underlying issues related to the sinuses, throat, or neck that may be contributing to your symptoms. Conditions such as allergic reactions, sinusitis, or even issues related to the lymphatic system could be explored.

2. Allergist/Immunologist: If your symptoms are triggered specifically by alcohol or certain foods (like the rice wine in your dishes), it may be worthwhile to consult an allergist. They can perform tests to determine if you have any food allergies or intolerances that could be causing your facial swelling and discomfort.

3. Neurologist: Given the involvement of facial swelling and potential nerve-related symptoms (like the sensation of tightness in the neck and increased eye pressure), a neurologist may also be able to provide insights. They can assess for any neurological conditions that may be contributing to your symptoms, including facial nerve issues or other nerve-related disorders.

4. Dermatologist: If there is a possibility that your symptoms are related to skin reactions or conditions, a dermatologist could help. They can evaluate for any dermatological issues that may be exacerbated by alcohol consumption, such as rosacea or other inflammatory skin conditions.

5. Gastroenterologist: If you suspect that your symptoms may be related to how your body metabolizes alcohol or if there are gastrointestinal issues at play, a gastroenterologist could provide valuable insights. They can assess for any digestive issues that may be contributing to your symptoms.

Additional Considerations
- Alcohol Intolerance: Some individuals have a genetic predisposition to alcohol intolerance, which can lead to symptoms such as flushing, swelling, and discomfort. This is often due to a deficiency in enzymes that metabolize alcohol.

- Histamine Reaction: Alcohol can trigger histamine release in some individuals, leading to symptoms like swelling and discomfort. Foods that are high in histamines, such as fermented products, can exacerbate this reaction.

- Transient Ischemic Attack (TIA): Although less likely, if you experience sudden changes in sensation or function, it is essential to seek immediate medical attention to rule out any serious conditions.

Conclusion
In summary, the best course of action is to start with an ENT specialist, as they can evaluate the structural and functional aspects of your symptoms. Depending on their findings, they may refer you to other specialists such as an allergist or neurologist. Keeping a detailed diary of your symptoms, including what you eat and drink, can also be helpful for your healthcare providers in diagnosing your condition. It is essential to address these symptoms promptly to improve your quality of life and prevent any potential complications.

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